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Highmark trying to 'destroy' health system after failed alignment


Highmark is using "predatory" tactics to "destroy" a three-hospital health system in Pennsylvania that declined to align itself with the market-leading insurer, officials claimed during a state Senate hearing Wednesday.

After Highmark decided to acquire the West Penn Allegheny Health System and build its own care provider network, the insurer also tried to acquire Excela Health, partner in its medical complex and gain majority ownership in Excela's provider network. But after Excela declined, Highmark said it would buy or affiliate with all independent practices on Excela's staff and build nearby ambulatory centers, reported the Pittsburgh Post-Gazette.

"The threat was clear--if Excela did not enter into an acquisition or affiliation with it, Highmark would use its monopoly position to destroy Excela," James Breisinger, chairman of the board for Excela, said during the state Senate Majority Policy Committee hearing.

Highmark even held a recruitment meeting with Excela's medical staff and offered preliminary contract offers to almost 20 Excela doctors, the Pittsburgh Business Times reported.

Sen. Kim Ward, who called the hearing, also challenged Highmark's recent tactics, accusing the insurer of dangling financial incentives in front of Excela physicians to lure patients to a hospital that's part of the West Penn system, reported the Pittsburgh Tribune-Review.

However, Highmark's executive vice president told lawmakers that it's committed to local hospitals. "Physicians aligning with Highmark will continue to extensively use the local facilities so that patients receive care in the local community," Deborah Rice said. She added that Highmark is still interested in "joint opportunities" with Excela and has no plans to steal doctors or steer patients to West Penn, the Post-Gazette noted.

Despite those reassurances, Ward remained skeptical. "Although I have heard repeatedly, from Highmark in particular, that they want to work with the community hospitals, their actions behind the scenes--setting up shell companies to buy up property and physicians in the counties surrounding Allegheny--tell a different story," she said.

To learn more:
- read the Pittsburgh Post-Gazette article
- see the Pittsburgh Business Times article
- check out the Pittsburgh Tribune-Review article

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