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Selective competition: UPMC should expand its one-year, one-site deal

Written by Susan Mannella on .

Question: How many people does it take to fill the 156 beds of the soon-to-open, state-of-the-art UPMC East hospital?

Answer: 25 -- UPMC CEO Jeffrey Romoff and the 24 directors of the UPMC board.

All they need to do is drop their opposition to negotiating a long-term contract with Highmark that would give its insurance customers in-network access to UPMC's hospitals and doctors.

The latest 10-year agreement between the region's dominant health care network and dominant health insurer runs out after June 30, 2013. Highmark would like a new multi-year deal, but UPMC has dug in its heels against one ever since Highmark acquired the financially ailing West Penn Allegheny Health System last year to maintain some degree of competition.

UPMC professes to want competition, too, but only on its terms -- like a one-year contract that would deliver Highmark customers to one UPMC hospital, the $258 million facility that will open in July not far from WPAHS's Forbes Regional Hospital in Monroeville.

The people of Western Pennsylvania, whose tax dollars and private donations have helped build UPMC, can understand UPMC's desperation to fill the beds in its new hospital. But why should they want to help UPMC when UPMC has told them, as 3 million Highmark customers, that, as of mid-2013, they'll be denied in-network access to its 3,000 doctors and more than 20 hospitals?

That's the thinking Highmark has espoused as well, by spurning UPMC's one-year, one-hospital offer.

UPMC charges that Highmark's refusal to accept the deal violates the two health industry giants' promise that Medicare, Medicaid and Children's Health Insurance Plan patients would not be affected by the nonprofits' impasse over a commercial contract.

But Highmark asks why should it send any of its patients to one UPMC hospital for one year, when they're likely to lose access thereafter?

UPMC says this shows Highmark is just "using their Medicare subscribers as pawns." And UPMC isn't treating 3 million Highmark customers as pawns?

It's a bitter new low in the region's uncharitable war between two charities, and Western Pennsylvania's people and employers are the ones being held hostage.

If, as UPMC says, giving Highmark subscribers in-network access to UPMC East promotes competition, then why not grant the same access to Highmark customers at all of its hospitals long-term?

Because UPMC doesn't compete that way.

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