Highmark, UPMC end negotiations as Aetna steps in

Provider agreement talks between Highmark and the University of Pittsburgh Medical Center appear to be irretrievably broken after UPMC signed a contract with Aetna that allows the health insurance giant to re-enter the local market, reports the Pittsburgh Business Times.

Highmark spokesman Michael Weinstein said the insurer "has and will continue to seek to negotiate new contract terms with UPMC, but to date UPMC has refused to do so," according to the Pittsburgh Post-Gazette.

After a 10 year absence, Aetna's re-entry into the Pittsburgh area health insurance market threatens to erode Highmark's dominance in the region while raising the prospect of lower insurance premiums for employers. Aetna essentially left the Pittsburgh market 10 years ago because it could not reach provider agreements for most of UPMC's hospitals and doctors.

UPMC's agreement with Aetna goes into effect July 1, affecting the January renewal period for businesses, traditionally the busiest renewal season, the Business Times notes.  

Meanwhile, Highmark, which controls more than 50 percent of the Pittsburgh health insurance market, is believed to be in discussions to form a partnership with UPMC's rival, West Penn Allegheny Health System, according to the Pittsburgh Tribune-Review.

To learn more:
- read the Pittsburgh Business Times article
- see the Pittsburgh Tribune-Review story
- check out the Pittsburgh Post-Gazette piece

Suggested Articles

Oscar Health will appeal a judge’s decision to toss its lawsuit against Blue Cross and Blue Shield of Florida over insurance broker agreements.

Physician-led ACOs generated nearly seven times more savings in 2018 than ACOs led by hospitals, a new analysis finds.

Most healthcare organizations are lagging in awareness and preparedness for compliance with proposed interoperability rules, according to a survey.