UPMC generated operating revenues in the healthcare sector of $12.4 billion and revenue of $10.5 billion, representing revenues of nearly 5% and 17% over the previous year. The payer`s arm grew by about 180,000 members during the year, although earnings from UPMC`s insurance business decreased slightly from 2018 due to start-up losses resulting from a new management contract with CHC Southeast Zone, higher medical claims costs and higher value payments compared to 2018, according to the company. The agreement, which will take effect on July 1, will ensure that Highmark Medicare Advantage and commercial listings have access to 11 UPMC hospitals and affiliated providers in the network. Highmark said it and UPMC will conclude the terms of the contract in the coming weeks. On the other side of the agreement, UpTM insurance holders will not suddenly have access to all facilities in the Allegheny Health Network. “I am proud to announce today this historic colony that restores equity and access to affordable care for the people of western Pennsylvania,” Shapiro said in a written statement. “Without this agreement, millions of patients… they would have abruptly reissued their health care. It is important to remember that five years ago, Highmark took courageous steps to preserve the choice of health care in this region by investing more than $2 billion in exceptional care and services provided by AHN in the Pittsburgh and Erie regions, including a nationally recognized heart team that offers the #1 state heart transplant program and a top 10 program in the country; a cancer institute that works with the renowned Johns Hopkins Cancer Centre to provide high-level cancer innovation and treatment capabilities; and a women`s health program that sets new standards for the treatment of women with postpartum depression. This agreement focuses on western Pennsylvania and has no impact on other regions. The unexpected agreement resolves a bitter and long-running struggle between rival health systems, which has raised doubts about the viability of exclusive supplier networks across the country. Patients and officials had protested against the threat of interruption of care. What is the impact of the Highmark and UPMC agreement on Medicare Advantage? UPMC believes in the importance of informed consumer choice and has always tried to ensure that, when UPMC is part of an insurance network, these members have full access to UPMC, with no contractual terms that are used to prevent or restrict the use of UPMC physicians and facilities.
This important consumer issue has been addressed collaboratively, and the UPMC network will now be available to Highmark members. UPMC believes that we were able to conclude this agreement with Highmark through a long-term network contract. The two parties had set up for the final separation on June 30, with Highmark`s Allegheny Health Network rapidly developing and UPMC planning three specialized clinics in the Pittsburgh area. A UPMC spokesperson said the problem had been resolved collaboratively, and UPMC “recognizes that we were able to reach this agreement with Highmark on a long-term network-based contract.” Does the Highmark and UPMC agreement include a complete network? Community Blue is an attractive Highmark option because of its lower costs, but subscribers knew there was no UPMC access and this agreement will not suddenly open up the doors of UPMC.