Jun 9, 2014 3 min read

PITTSBURGH – The Pittsburgh Business Group on Health said Monday it launched, “The Priority Initiative,” a campaign aimed at expediting the discussion between Highmark and UPMC regarding their ongoing contract dispute.

The unresolved dispute is expected to disrupt the lives of hundreds of thousands of employees and their families from PBGH employer-member companies when Highmark’s contract with UPMC expires Dec. 31.

PBGH said in a news release if an agreement cannot be reached by the deadline, many Highmark subscribers will lose in-network access to UPMC doctors and hospitals. UPMC said it will not renew its contract with Highmark.

According to Jessica Brooks, PBGH executive director, PBGH, one of the country’s premier employer coalitions dedicated to improving the delivery, cost and quality of benefits and health care, “There needs to be a greater sense of urgency on the part of Highmark and UPMC to resolve outstanding issues and publish complete transitional plans so employers can make good, sensible decisions about their company’s health care plans.”

According to Brooks, the July 31 Pennsylvania Insurance Department deadline is too late for businesses.

“Employer decisions are being made now, so it’s too important to wait for resolution or comprehensive work plans for transition of care,” said Brooks.

The most recent war of words between the two entities emerged in May during a PBGH-hosted employer-member forum, “The Impact to Employers and the Region: Making Sense of the UPMC and Highmark Contract Debate.”

During the forum, Highmark said nearly 70 percent of UPMC-employed physicians would remain in Highmark’s network next year based on a methodology both sides agreed upon with the state insurance department. UPMC, however, disagreed, saying there was no agreement for physicians to be in-network for Highmark subscribers, except for services provided at specific sites and was nowhere near 70 percent.

“The nation is watching Pittsburgh and how we handle the fallout from the lingering contract dispute,” said Brooks. “We should be a model for care and compassion, not bickering.

“PBGH employer-members need the necessary information to make an informed decision about issues impacting employees and are growing weary about the unending barrage of ‘he-said, she said’ from UPMC and Highmark. We want the resolution to this matter to be a priority.”

According to Brooks, the organization’s board of directors has authorized her to launch a number of strategies for The Priority Initiative on behalf of PBGH employer-members and stakeholders, including:

• Requiring UPMC and Highmark to set-up more face-to-face meetings to finalize details of how a no-contract future will look (i.e., transition of care, emergency room visits, in-network access, etc.), as well as pooled statements from both sides after meetings occur.

• Direct correspondence with both Gov. Tom Corbett and Democratic Gubernatorial candidate Tom Wolf to ensure employers’ concerns are represented and are a priority relative to any intervention.

• Elevated involvement from the Pennsylvania Insurance Department requesting a meeting to seek clarity about the contract negotiations, as well as the disagreement regarding in-network access.

• Increased involvement from the state Department of Health relative to their role in the dispute and what, if anything, the DOH is prepared to do in the coming weeks to address lingering contract specifics.

• Invitation to other organizations to participate in The Priority Initiative as a show of support for employers and their employees.