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Highmark, UPMC To Part Ways

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(Photo Credit: KDKA)

(Photo Credit: KDKA)

CBS Pittsburgh (con't)

Affordable Care Act Updates: CBSPittsburgh.com/ACA

Health News & Information: CBSPittsburgh.com/Health

PITTSBURGH (KDKA) — There is a huge change coming in health insurance for millions of people in Pennsylvania as UPMC and Highmark are parting ways.

UPMC, the area’s largest health care provider says it won’t renew its contract with Highmark, the area’s largest health insurer.

It stems from Highmark’s reported efforts to acquire the West Penn Allegheny Health System.

UPMC says: “With Highmark having announced its intention to compete with UPMC as a provider, there cannot be any prospect of a contract renewal between UPMC and Highmark.”

The contract expires June 30, 2012.

One of the area’s largest health care consultants says consumers can expect to pay more.

“Most employers, most employees end up having to spend a little bit more for coverage now because the cost of health care is so expensive,” said Lorin Lacy, of Buck Consultants. “So, it’s already straining budgets for consumers today and this will only make it worse in that regard, I believe.”

Highmark subscribers can continue to use UPMC hospitals until June 2013, but may have to get permission first and pay higher fees.

However, UPMC’s 2,800 doctors would be out of network, which some Highmark subscribers say would cost too much.

“I wouldn’t be able to pay and I’d have to scramble to find someone,” said Andrea Fedoronko, a Highmark subscriber. “In a year, that doesn’t give you much time.”

Highmark says “We will take every measure necessary to protect our members and to make sure they can continue to receive uninterrupted care at UPMC physicians and UPMC hospitals through mid-year 2013 with no special approvals or permissions required while reimbursing UPMC physicians as in network providers.”

But UPMC says that won’t happen.

After next June and for several years, Highmark subscribers would continue to have access to just two UPMC hospitals, Children’s Hospital and Mercy Hospital.

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