Consumers unsure how Highmark-UPMC breakup impacts them


With the contract between Pennsylvania health giants Highmark and the University of Pittsburgh Medical Center ending today, many consumers are uncertain how the separation will impact them, the Pittsburgh Tribune-Review reported.

After the insurer and health provider decided to stop working together this summer, they entered a consent decree allowing Highmark members to continue using UPMC providers at in-network rates. But, in reality, those members won't have unlimited access to UPMC doctors, who are among the region's biggest network of providers. For example, the consent decree says that emergency care is always in-network, but it's unclear whether Highmark's senior members will have access to UPMC providers.

"I'm sure there's going to be some land mines, just from an administrative viewpoint," James McTiernan, a healthcare consultant with benefits firm Triad Gallagher, told the Tribune-Review. "I'm sure along the way there will be disputes and misunderstandings."

To learn more:
- read the Pittsburgh Tribune-Review article

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