Highmark files West Penn merger papers with state
(AP) PITTSBURGH — Health insurer Highmark Inc. has filed a document with the Pennsylvania Insurance Department relating to its planned $475 million takeover of the West Penn Allegheny Health System, a Pittsburgh-based hospital network.The department announced the filing on Monday, but said the document won't be available for review by the public until Wednesday, when it will be posted on the department's website.
The documents deal with "proposed changes in control of Highmark and its subsidiary insurance entities" that must be vetted for the acquisition to be approved by the state insurance department.
Among other things, the department must determine whether the takeover will lessen competition, be more efficient or whether it will help or hurt customers.
"We will focus on licensure, solvency, business plans and management, as well as the impact the transaction could have on competition and consumers," state Insurance Commissioner Mike Consedine said in a statement.
Highmark announced it had a signed agreement with the six-hospital West Penn network last week. The move comes as Pittsburgh-based Highmark and the University of Pittsburgh Medical Center Health System, continue to publicly feud about an insurance contract that is set to expire at the end of June.
Highmark has said it wants to renew the contract, which would enable its 3 million subscribers to continue using UPMC's 2,700 doctors at in-network rates. UPMC is western Pennsylvania's dominant health care network with 19 hospitals and several other facilities.
But UPMC officials have rebuffed Highmark's overtures — and suggestions by state lawmakers that they ought to cut a deal and renew the contract — saying that Highmark's takeover of West Penn now makes the insurer and UPMC direct competitors.
Upmc Health Insurance Pa - News
Highmark has said it wants to renew the contract, which would enable its 3 million subscribers to continue using UPMC's 2700 doctors at in-network rates. UPMC is western Pennsylvania's dominant health care network with 19 hospitals and several other
Rice added that even though UPMC has competed with Highmark as a health insurer for more than 10 years through its UPMC Health Plan, “Highmark has not hesitated to work with UPMC as a health care provider.” If the two sides ultimately do not come to an
estrogen as a potential cause of prostate cancer, it is too early to say," said Jian-Min Yuan, MD, PhD, epidemiologist and newly appointed associate director of the University of Pittsburgh Medical Center (UPMC) Cancer Institute in Pennsylvania.
The company also sells health management, claims management and benefits administration products. UPMC's insurance services division offers health insurance and supplementary Medicare and Medicaid products, but most of its customers lie in ancillary
health insurer, Highmark Inc. Their current deal expires next July meaning Highmark's 3 million subscribers could wind up paying more for services through UPMC, a 19-hospital network with hundreds of doctors which dominates western Pennsylvania.
When health care giants collide: UPMC vs. Highmark — What If Post
UPMC, as you’ve surely heard, has announced that in 2012 it will not renew its contract with Highmark, which insures more than 3 million Western Pennsylvanians. The reason: Highmark is seeking to merge with the Western Pennsylvania Allegheny Health System (WPAHS), UPMC’s rival hospital network. UPMC says it can’t be expected to do business with a direct competitor, although UPMC operates a health plan that’s been encroaching on Highmark’s turf for years.
The Highmark merger rescues WPAHS, by providing badly needed cash and loans , but it comes at a price. If Highmark’s contract with UPMC isn’t renewed, many patients could lose access to UPMC doctors and hospitals. They wouldn’t be denied service, but they would be charged the out-of-network rate.
The Beaver County Times points out that typically out-of-network services are only covered to 70%: “So an operation such as cataract surgery that would cost $3,800 would be covered only up to $2,660 if performed out of network, leaving a $1,140 bill for the patient, plus his deductible.”
ChoiceOne of UPMC’s arguments is that customers can simply move to other insurance companies that have recently signed contracts with them. The health system issued this statement :
“UPMC stands by our physician contract terminations. People should assure that they have access to UPMC physicians and hospitals now available to subscribers to UPMC Health Plan, Aetna, Cigna and United Healthcare, along with other potential national insurers. Only Highmark will not have UPMC physicians and hospitals in their network. This represents real choice in health insurance… .”
thing for the region. Wait, why is a giant insurance monopoly good for Pittsburgh?