UPMC and Blue Cross Agreement: What You Need to Know
In a major breakthrough for healthcare consumers in Western Pennsylvania, UPMC and Highmark Blue Cross Blue Shield have finally reached an agreement. The two healthcare giants have been at odds for years, causing uncertainty and frustration for patients who were caught in the middle. However, with this new agreement, patients can now seek care at UPMC hospitals and doctors while remaining in-network with their Highmark insurance plan.
The agreement, which was announced in June 2019, will remain in effect until June 30, 2024. This means that patients with Highmark insurance plans, including Medicare Advantage, can now seek care at UPMC hospitals and doctors without having to pay out-of-network costs. The agreement also means that patients who receive care at UPMC facilities will be able to maintain their relationships with their current doctors and specialists, as well as receive the treatments and services they need.
What led to the agreement?
The feud between UPMC and Highmark has been long and complex. It started when Highmark announced plans to acquire the West Penn Allegheny Health System, a competing healthcare provider in the region. UPMC, which has long been the dominant healthcare provider in Pittsburgh, saw this as a direct threat to its market share and responded by ending its contract with Highmark in 2012.
Since then, patients have been forced to choose between UPMC and Highmark, with many opting for Highmark in order to maintain their relationships with their doctors. However, this meant that they could no longer receive care at UPMC facilities. The feud between the two providers has been so intense that it even led to state lawmakers stepping in to try and negotiate a truce.
What are the benefits of the agreement?
The new agreement between UPMC and Highmark is a win for patients in Western Pennsylvania. It means that patients can now choose the healthcare provider that best meets their needs without having to worry about whether their insurance plan will cover the cost. Patients who have been receiving care at UPMC facilities but were forced to switch to Highmark due to insurance coverage can now return to their preferred healthcare provider.
The agreement also means that patients can continue to receive care from their current doctors and specialists. This is particularly important for patients with complex medical conditions who require ongoing care and treatment.
What`s next?
While the agreement between UPMC and Highmark is a positive step forward, there is still much work to be done to improve healthcare access and affordability in Western Pennsylvania. For example, many patients still struggle to afford the high cost of healthcare, even with insurance coverage. There is also a shortage of primary care doctors in the region, which can make it difficult for patients to get the care they need.
Overall, the UPMC and Highmark agreement is a positive development for healthcare consumers in Western Pennsylvania. It`s an example of what can be achieved when healthcare providers work together to put patients first. As the healthcare industry continues to evolve, we hope to see more collaboration and innovation from healthcare providers to improve the health and well-being of their patients.