Highmark plan seen as riskier than ever

From the start, Highmark Inc.'s plan to assemble an in-house provider network was viewed as audacious and financially risky. A successful integration of West Penn Allegheny Health System—the centerpiece of the under-construction provider network—would give insurers nationwide a new way forward as they dealt with health care costs that always seem to trend skyward. But if Highmark were to gamble and lose, a failed merger would be another reminder why these sorts of insurer-hospital shotgun marriages didn't work in the 1980s and 1990s, when big insurers began to disband managed-care networks, shed their physicians clinics and sell their hospital systems.