PITTSBURGH (KDKA) — David Holmberg has been Highmark’s CEO for just eight weeks.
And the region’s largest insurance company — that now provides health services through its Allegheny Health Network — has been embroiled with UPMC.
Holmberg was at KDKA-TV for a taping of the Sunday Business Page, his first TV interview since becoming CEO, but before the show he talked with KDKA money editor Jon Delano about the thousands of subscribers who will soon be denied care at UPMC facilities at lower in-network costs — and be forced to go elsewhere, including Highmark’s own Allegheny Health Network.
Delano: “Are you convinced that we can get the same level of care at an Allegheny Health Network hospital as we do at UPMC?
Holmberg: “Unquestionably. I would tell you we’ve had some recent examples of that where the Allegheny Health Network has done extraordinary things.”
Holmberg denies UPMC’s charge that Highmark wants to push customers to Allegheny General, West Penn, Jefferson and other AHN hospitals.
“We’re not forcing our people to go anywhere,” says Holmberg. “I think what’s unique about us is that we’re not interested in filling hospital beds. What we’re interested in doing is keeping people healthy because we’re responsible for the total healthcare relationship with people.”
Still, effective Jan. 1, because UPMC won’t renew its Highmark contract, most Highmark customers will have to use non-UPMC doctors and facilities.
Holmberg was asked if UPMC won this battle.
“You know, I am not a politician, so I am not going to get in the middle of that component of it,” said Holmberg. “My job was to protect the patients and the members and the people of western Pennsylvania, and we believe that what we’ve done is protected those that are most vulnerable.”
That includes those 65 and over, those in the middle of critical treatment at UPMC, those with cancer-related illnesses, and those who need Emergency Room treatment.
Holmberg stresses their traditional Blue Cross mission.
“Keep people healthy. Keep them in the neighborhoods. Keep them out of the hospital. And that’s the difference between us and maybe other folks,” he said.
The new Highmark leader knows change is coming quickly.
“Consumers are going to be asked to make more of their decisions in health care than they ever had before. Not only are they going to have to pick insurance, they’re going to have to pick the doctors they want. They’re going to have to pick the hospitals they want to be a part of,” he added.
With a strong consumer retail background, Holmberg intends to position Highmark as the best — and most affordable — choice for both insurance and health care services in this region.
“We also have responsibility for making sure the family is financially standing after they’ve gone through a health care crisis. That’s very important to us,” he said.
Holmberg says he wants to set aside the rancorous relationship with UPMC and its CEO, Jeffrey Romoff.
“I’m not as emotional as previous folks might have been about the relationships,” noted Holmberg.
Delano: “Have you met Jeffrey Romoff?”
Holmberg: “I have not.”
Delano: “Have you talked to Jeffrey Romoff on the phone?”
Holmberg: “Jeff and I agreed that until we resolved all this it’s probably best that we don’t catch up.”
But already there’s a dispute over what the ‘Patients First’ agreement negotiated with the governor and attorney general really means with UPMC narrowly interpreting who gets UPMC services after Jan. 1.
“What the agreement says is that the deciding person in that is the patient and the physician,” said Holmberg. “I think it is very, very important that the physician lead that and make the decision.”
Highmark insists that all its patients using UPMC currently be protected.
“There’s 18,252 people that we identified that were Highmark members that were in the middle of critical care that I personally felt responsible to,” noted Holmberg.
But whether they will be protected could be a future battle.