'Tiering and steering' a contentious issue for local healthcare

"Tiering and steering" is the catch phrase at the heart of the three-year dispute that threatens to end the UPMC-Highmark relationship. Health provider UPMC believes if it signs a contract with Highmark after this year, the Pittsburgh insurer will assign UPMC's doctors and hospitals to its most expensive tier in order to recoup the billions of dollars it is spending to develop its own provider network. By making it more expensive to get care through UPMC operations, patients would be "steered" to hospitals in Highmark's Allegheny Health Network. "There will not be a contract, there cannot be a contract, because we cannot put the fate of UPMC into the hands of Highmark," said Robert DeMichiei, UPMC's chief financial officer.