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Friday, June 27, 2014

Highmark, UPMC Reach Agreement

Highmark and UPMC have reached a comprehensive transition agreement that covers how and where patients can receive health care after the contract between the two organizations expires next year.

The agreement between the healthcare giants addresses vulnerable populations, emergency services, cancer patients, unique hospitals and doctors, and includes a one year safety net for any existing patient who cannot find alternative doctors and services.

While the agreement is not an extension of the current contract between Highmark and UPMC, it does preserve in-network access to specialty hospitals, emergency rooms and certain treatment facilities. And, it addresses coverage for Medicare.

Senator Sean Wiley of Erie says the agreement will have a significant economic impact on the region.

"Another element of this is, UPMC Hamot is the only trauma care hospital in the area, and so when you have that element to it, it's just the responsible thing to do to make sure we have this impasse lifted."

If trauma patients could not go to Hamot, they would most likely be sent to ECMC in Buffalo.

Officials say the agreement offers a framework for a transition plan when the contract between the health system and insurer expires at the end of the year.

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