'Coupled with that we are very unique,' Paul says. 'This is the first time in this country where a very large insurer is entering into the provider business to the extent that we are here at Highmark. So our incentive is to be sure we keep care in the most affordable setting, keep care local, [and] make it very convenient for our enrollees. Thus we can keep that membership.'
The deal is the latest twist in the battle for market share in Western Pennsylvania with rival University of Pittsburgh Medical Center. Winkenwerder said Monday Highmark hopes to have a relationship with UPMC going forward, even though their current contract will expire at the end of the 2014.
UPMC appeared less enthusiastic and issued a statement following the commissioner's approval noting that 'Highmark's ownership of a provider network introduces more complicated insurance choices for employers and consumers.'
'We urge Highmark to immediately join with UPMC in preparing its subscribers for the transition that will take place on Dec. 31, 2014, when the UPMC-Highmark contract expires,' UPMC's statement read. 'It is important that consumers understand these changes so they can take the steps needed to continue accessing their preferred doctors and hospitals. We urge Highmark to work with UPMC now as there will be no new UPMC contract or extension when the current one expires in just 19 months.'
Monday's approval by Pennsylvania Insurance Commissioner Michael Consedine caps a process that began with Highmark's initial filing in November 2011 through its nonprofit corporation, UPE. Consedine called the review of the deal the most complex and extensive in his agency's history, with a record that includes more than 64,000 pages of reports and analytical data, more than 10,000 pages of public comments and more than six hours of public testimony.
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.