UPMC shifts course
A change of heart or a tactical ploy?
UPMC rocked the region the past two days when the health care behemoth made two unwieldy turnabouts. On Wednesday, UPMC announced a rollback of an onerous prepay protocol that was to have taken effect July 1 for many elderly Highmark members. These Medicare Advantage subscribers no longer face forced payment in advance of service at UPMC facilities and from UPMC providers.
Next came the news that UPMC had decided that cancer patients could continue to receive care at innetwork prices at Hillman Cancer Center sites regardless of their brand of insurance. Cancer patients are the single biggest subset within the medically fragile group covered by soon to expire consent decrees between UPMC and Highmark. (No word about the rest of those covered by the decrees: the transplant patients, those with chronic conditions like diabetes and autoimmune disorders.)
The timing of these left-turn policy changes suggests a tactical move rather than a change of heart by UPMC CEO Jeffrey Romoff.
UPMC is to stand before Commonwealth Court on Monday, defending itself in litigation launched by state Attorney General Josh Shapiro who has contended that UPMC does not conduct itself as a charitable nonprofit. First on the agenda of wideranging matters to be litigated is whether the June 30 expiration of the consent decrees could be modified — as in extended at least through the end of the litigation.
Then came two unexpected
announcements from UPMC and, voila! The guts of the consent decrees are preserved by UPMC’s own hand.
Did Mr. Romoff see the light, read the tea leaves or, like a plummeting plane, dump its fuel in the hopes of gaining more maneuverability before crash landing?
Mr. Shapiro thinks it a “coordinated last-minute ploy” before David faces Goliath in Commonwealth Court.
Highmark is skeptical, too. A spokesman for the UPMC nemesis said “none of the recent UPMC announcements are part of ongoing talks with UPMC. We are learning of them through the news ... [W]e need to secure contract language and agreements so that their practices align” with their public comments. Indeed.
And Allegheny County Controller Chelsa Wagner, who has long led a protest of UPMC’s predatory behaviors, put it most bluntly: “When a robber baron tries to convince us he’s Santa Claus, we should all remain very skeptical.”
Regardless of motive or possible stratagem, the needle has moved in the right direction.
Mr. Romoff, prove your nay-sayers wrong: Withdraw from the litigation entirely. Voluntarily extend all terms of the consent decrees in writing immediately. Use those decrees as a placeholder while you return to the bargaining table with Highmark to negotiate in good faith for a business arrangement that benefits not just the senior citizens and cancer patients, but everyone in our community.