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UPMC Demands Increased Cancer Payments From Highmark
UPMC is threatening to lock Highmark's Medicare Advantage customers out of its hospitals, a move Governor Tom Wolf calls "unacceptable."
The University of Pittsburgh Medical Center (UPMC) is threatening to lock Highmark’s Medicare Advantage customers out of its hospitals and clinics starting Jan. 1, a move Pennsylvania’s governor calls an “unacceptable” violation of UPMC’s commitment to keep senior citizens out of the crossfire between the 2 Pittsburgh health rivals.
UPMC, Pittsburgh’s largest hospital and physician network, has told the state it will make good on the threat unless Highmark, the state’s largest health insurer, agrees to increase cancer payments to the hospital system, and agrees to drop a lawsuit related to those oncology payments. About 182,000 Western Pennsylvania seniors have a Highmark Medicare Advantage policy, and if the dispute isn’t resolved in the next eight months, those seniors could lose in-network access to UPMC — unless they leave Highmark in favor of another insurance carrier.
Read the complete report by Pittsburgh Post-Gazette: http://bit.ly/1Ps6ZLM
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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