The clock is ticking for people with Highmark Healthcare plans to change their doctors. And now, we’ve learned people with UPMC premium plans could also have to make the switch.
The clock is ticking for people with Highmark Health care plans to change their doctors.
And now, we’ve learned people with UPMC premium plans could also have to make the switch.
Both providers are still facing a split in their network connections with each other, when their five-year consent decree expires on June 30.
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“Yeah, I’ll be worried.” said Jean Merryman
Merryman has held a Highmark card for years, but most of her doctors are in the UPMC network. And with just over a month before card holders like her face the possibility of losing that connection, Merryman knows it won’t be easy.
“It’s just an inconvenience, and I like them.” Merryman said
And at Highmark, they’re working with people like Merryman, to make sure they’re prepared for the potential split, while also keeping an eye on an ongoing legal battle which could prevent the split altogether.
“There’s a lot of confusion in the market right now.” Said Vice President of Regional Markets at Highmark Health, Jim Teed
And Teed says the provider is walking a fine line.
As Pennsylvania Attorney General, Josh Shapiro is suing UPMC, to allow Highmark patients to have continued access, a choice which Teed says, Highmark stands by. Shapiro contests that in order for UPMC to maintain its status as a nonprofit, it has to be open to all patients, regardless of insurance.
And if Shapiro does not win in the courts, not only will cardholders lose access to the UPMC network, but, Erie News Now has confirmed, some UPMC members will lose their access to Highmark.
It’s a move Teed says needs to be done in order to keep the market even.
“We don’t have a choice.” said Teed
Teed says Highmark cardholders will still have access to some ‘exception’ hospitals in the UPMC network, which include UPMC Chautauqua in Jamestown, New York.
Though, with the future uncertain, Teed says Highmark has been preparing for the worst and has helped cardholders connect to doctors within their network for the past several years.
The provider has hosted several “Meet Dr. Right” events, which Teed says has helped arrange over 2500 appointments.
“We’re ready and our membership is ready.” Teed said
And he hopes even more people like Merryman can be ready to go, too.
“I’ll be alright.” said Merryman
Shapiro’s first hearing with the State Supreme Court will take place on May 16. Another hearing will be held at a later date.
Teed says Highmark does not plan to host another Dr. Right event before June 30. In the meantime, you can still connect with a doctor by visiting their website.
He says Saint Vincent Hospital in Erie is prepared for the switch, and a transition team has been set up.
We reached out to UPMC Hamot for comment, but we were told they would not comment at this time.
Date: May 07, 2019
Source: ERIE NEWS NOW