Under a current consent decree with state regulators signed in June 2014, Highmark Health insurance members have access to Children’s Hospital of Pittsburgh of UPMC and Western Psychiatric Institute & Clinic in Pittsburgh through 2022 and 2019, respectively.
Highmark members will be required to pay out-of-network rates for care once the decree with the state expires, according to the report.
During the panel discussion Tuesday, hosted by the Pittsburgh Business Group on Health, Mr. Holmberg said both hospitals should be open to patients regardless of their health plan.
“I’ve been very clear … Children’s Hospital of Pittsburgh should never be in play here. These are charitable assets and they should be available to the community,” Mr. Holmberg said. “I can’t imagine anyone in healthcare denying access to [the] Children’s Hospital. I don’t believe [UPMC president and CEO] Jeff Romoff would deny access to the community.”
Mr. Holmberg also said he would like Highmark plan holders to have continued open access to UPMC hospitals in areas where UPMC is one of the only health providers in the area.
More articles on payer issues:
Montefiore Health System goes out of network with UnitedHealthcare’s Medicare Advantage plan
UnitedHealthcare unveils value-based Medicare Advantage program with Oak Street Health
Fitch: CVS Health-Aetna ‘prime example’ of healthcare’s focus on pricing power
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
