Penn­syl­va­nia blood feud prompts em­ployer to drop High­mark

Modern Healthcare - - REGIONAL NEWS - —Bob Her­man

Erie In­dem­nity Co., an Erie, Pa.based company that pro­vides au­to­mo­bile, home and life in­surance, has de­cided to drop High­mark as the health plan for its 4,600 em­ploy­ees be­cause of the on­go­ing blood feud be­tween in­surer High­mark and hos­pi­tal gi­ant UPMC. Its decision could be a har­bin­ger of what other Western Penn­syl­va­nia em­ploy­ers will do next year as they seek to find shel­ter from the fall­out of the bat­tle.

Erie will switch to United Health­care, the largest health in­surer in the coun­try. Becky Du­den­ho­ef­fer, vice pres­i­dent of company ben­e­fits, said in a memo the change will go into ef­fect Jan. 1. “The on­go­ing UPMC-High­mark dis­pute in western PA has con­cerned many of our em­ploy­ees,” ac­cord­ing to the memo. “As mem­bers of the United Health care net­work, em­ploy­ees will no longer have to worry that they would be re­stricted to ei­ther High­mark or UPMC providers.”

This month, High­mark and UPMC out­lined terms of a gov­ern­ment-bro­kered agree­ment. Ef­fec­tive Jan. 1, the con­tract be­tween UPMC and High­mark ex­pires. Although seven UPMC hos­pi­tals and thou­sands of em­ployed spe­cial­ists will still be con­sid­ered in-net­work for High­mark mem­bers, UPMC’s six ma­jor hos­pi­tals and doc­tors who per­form pro­ce­dures there will be out of net­work.

Erie is not the first em­ployer to drop High­mark re­cently. Last year, West­ing­house Elec­tric Co., based in Cran­berry Town­ship, Pa., just north of Pitts­burgh, switched from High­mark to Aetna.

New terms for High­mark’s con­tract

with UPMC take ef­fect Jan. 1.

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