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News & Releases For Mercyhurst University's School of Health Professions and Public Health

Erie Times-News: UPMC Asks Highmark for Hamot Contract
Posted on Tuesday, October 29, 2013 at 2:39 PM
This is a June 2011 file photo of UPMC Hamot in Erie. It was photographed on June 16, 2011. ROB ENGELHARDT//ERIE TIMES-NEWS

People with Highmark insurance might still have access to UPMC Hamot after the University of Pittsburgh Medical Center's provider contract with Highmark expires Dec. 31, 2014.

UPMC officials asked Highmark in July if the Pittsburgh-based health insurer would negotiate a new contract with the Erie hospital, Highmark spokesman Aaron Billger said.

"UPMC came to us about extending a contract with UPMC Hamot and UPMC Altoona," Billger said. "We welcome the opportunity."

The news comes as a bit of a surprise, considering how adamantly UPMC officials have spoken about not negotiating a new contract with Highmark when the current one runs out.

In interviews and commercials, UPMC has said it won't enter a new agreement with Highmark because UPMC sees the health insurer as a competitor since Highmark created the Allegheny Health Network. The integrated delivery system encompasses seven hospitals, including Saint Vincent Hospital.

UPMC Hamot spokeswoman Carly Manino referred questions to UPMC spokesman Paul Wood, who did not return phone or e-mail messages Tuesday.

"I'm a little surprised given the strength of UPMC's rhetoric and what I interpreted as 'no room for discussion' language UPMC was using," said David Dausey, dean of Mercyhurst University's School of Health Professions and Public Health. "I think UPMC is extending this olive branch because it has taken a hit in this region in terms of what access people will have."

Don't expect Highmark and UPMC to agree in the near future on access to Hamot. The two health-care organizations are currently negotiating a provider's contract for the "exception hospitals" identified in Gov. Tom Corbett's mediated agreement in 2012.

Those hospitals include UPMC Northwest, UPMC Bedford Memorial, Hillman Cancer Center and Western Psychiatric Institute and Clinic. Children's Hospital of Pittsburgh at UPMC is under a separate agreement with Highmark that doesn't expire until 2022.

"We first need to finish negotiating and have contracts in place for the already identified 'exception hospitals,'" Billger said. "At that time, we would hope that Hamot and Altoona would be part of a broader Highmark-UPMC contract."

If a provider contract is not extended, those with Highmark insurance would no longer have access to Hamot and most other UPMC hospitals and employed doctors after 2014.

Even if a contract is signed, Billger said Highmark would likely continue to offer plans like Community Blue, which exclude most UPMC hospitals and doctors.

"We want to offer a variety of plans to consumers," Billger said. "Some are based on cost and some are based on coverage. The consumer should be able to choose the coverage, not a single health-care entity."


DAVID BRUCE can be reached at 870-1736 or by e-mail.  Original source.


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