UPMC and Highmark, both in Pittsburgh, inked a deal ensuring Highmark policyholders in-network access to UPMC's community and specialty hospitals.
Here are four things to know about the agreement.
1. The Jan. 4 deal includes 10-plus UPMC Pittsburgh-area specialty hospitals and community hospitals statewide where UPMC is the only provider.
2. The agreement between the rival health systems has been in the works since August, the Pittsburgh Post-Gazette reports. UPMC and Highmark signed consent decrees in 2014 providing in-network access for the companies' customers. However, those agreements expire at the end of June 2019.
3. The new agreement assures Highmark policyholders in-network status for UPMC's joint venture cancer programs through 2021 or 2024, depending on the hospital. Community hospitals under the agreement will see in-network access extended to Highmark members until 2024 or 2025. A separate deal ensures Highmark policyholders will have access to Children's Hospital of Pittsburgh of UPMC providers at in-network rates until 2022.
4. Some Highmark members could still face out-of-network prices at several other Pennsylvania hospitals in 2019. These locations include Erie-based UPMC Hamot, Greenville-based UPMC Horizon, Hillman Cancer Center in Pittsburgh and just about every other UPMC community hospital in Allegheny County, the Pittsburgh Post-Gazette reports.
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