UPMC announced Thursday that the Hillman Cancer Center would accept all insurers, including Highmark commercial and Medicare Advantage plans.
The announcement comes less than a month before an agreement between the two health care systems expires, and the day after UPMC reversed a policy that would have required all Highmark Medicare Advantage patients to pre-pay their bills before receiving care.
“We’ve heard recently from a lot of people and a lot of Highmark members, and they’ve testified about their missed diagnoses, they’ve praised Hillman for saving lives. They’ve talk about how they’d die if they go elsewhere… So, we listened,” said Paul Wood, UPMC vice president of communications.
This is the latest development in a years-long saga that began in 2012 when UPMC announced it would no longer accept Highmark insurance. That happened the year after Highmark acquired its own health care system, putting it in direct competition with UPMC, which until then was the only entity in western Pennsylvania providing both health insurance and medical care.
In 2014, the state stepped in to facilitate an agreement between UPMC and Highmark, so as to provide a transition period and prevent patients from being abruptly cut off from their medical providers.
With the 2014 agreement expiring at the end of this month, many are petitioning UPMC to revert to its pre-2012 policy and accept Highmark customers at all its facilities. Wood said there are no plans for that.
“This is a very positive announcement from the community,” he said. “We should just take it as it is."
Wood added that Highmark has a poor reputation of paying medical providers for services. He said the Hillman decision comes after a meeting with Pittsburgh Mayor Bill Peduto and Allegheny County Allegheny County Executive Rich Fitzgerald.
“These first steps continue to move us toward the goal of providing greater health care access for our region’s residents,” said Peduto and Fitzgerald in a joint statement. “This is how progress happens – by continuing to work together and engaging with all parties.”
UPMC previously announced that Children's Hospital of Pittsburgh and Western Psychiatric Hospital would also accept in-network insurance from other insurers, including Highmark.
Before this announcement, many Hillman patients insured by Highmark were extremely concerned about their ability to find new medical providers. While these patients might feel relief, it is by no means a satisfying outcome to everyone.
“I have five specialists and they all work out of [UPMC] St. Margaret’s hospital, the same hospital, and they know each other,” said Highmark customer Evie Bodick during an interview with WESA last month. “They know me, know my body, they know my allergies, and they get together and converse with one another, like what is the plan of action to do for me.”
Bodick said she is a survivor of both lung and breast cancer. If she were to switch to Allegheny Health Network, Highmark’s health care system, she’d have to start over with an entirely new team of doctors who are not based at the same facility.
“I’d have to go to Allegheny General, West Penn for another, and so forth and so forth,” she said. “How are they going to communicate with each other? They won’t know me.”
People like Bodick have been speaking out for months in hopes of getting UPMC to change its mind. There has also been legisiaton proposed, and state Attorney General Josh Shapiro is currently suing UPMC to force it to accept Highmark insurance.
Shapiro called the Thursday announcement a “coordinated last-minute ploy, which UPMC could rescind at any moment and leave patients without care.”
Highmark spokesperson Aaron Billger agreed that access to Hillman needs to be formalized.
“We need to secure contract language and agreements so that their practices align with their commitments,” said Billger. “We look forward to working with the Attorney General and UPMC, if UPMC is willing to work in good faith.”
WESA receives funding from Highmark and UPMC.