Last week, on June 14, Judge Robert Simpson of the Pennsylvania Commonwealth Court ruled that the 2014 consent decree that governed the agreement between UPMC and Highmark cannot be extended past its June 30 expiration date.
HARRISBURG, Pa., June 18, 2019 /PRNewswire/ -- Last week, on June 14, Judge Robert Simpson of the Pennsylvania Commonwealth Court ruled that the 2014 consent decree that governed the agreement between UPMC and Highmark cannot be extended past its June 30 expiration date. As a result, Pennsylvanians with Highmark health insurance may no longer have automatic access to the UPMC provider network.
“As a result of this ruling, a major Pennsylvania healthcare market is effectively being cleaved into two camps, which forces patients and physicians to choose participating in closed and exclusionary networks on the basis of opaque insurance economics—not what is in the best interest of UPMC Health Plan’s and Highmark’s members,” says Jaan Sidorov, MD, CEO and President of the PA Clinical Network.
Sidorov adds, “We continue to believe that one solution to insurer market domination is independent, physician-led clinically integrated networks that can have contracted relationships with multiple health insurers.”
Physician-led clinically integrated networks are created to work with multiple insurance plans and businesses simultaneously in order to develop collaborative agreements that sustain increased healthcare value. One example of such an independent network is the PA Clinical Network, which is made up of hundreds of private practice physicians across Pennsylvania, including the Pittsburgh market.
In the Pittsburgh market, the PA Clinical Network includes Genesis Medical Associates as well as numerous independent physician practices.
“As a high quality, physician-owned practice, we see all patients regardless of insurance. As the market trends toward less access for patients to all types of clinicians, the PA Clinical Network places a premium on patient choice—once again reinforcing the significant value of the independent physician,” says Mark Kissinger, Executive Director of Genesis Medical Associates.
About the PA Clinical Network
The PA Clinical Network is part of the Care Centered Collaborative. The Collaborative was created in 2016 by the Pennsylvania Medical Society to better promote and enable collaboration among physician-led practices and networks. It offers strategic partnerships to help physicians more confidently participate in value-based healthcare models and contracts. The PA Clinical Network, a bona fide clinically integrated network (CIN) for independent practices, provides physicians and their care teams the tools, resources and expertise to achieve the highest levels of patient-centered outcomes. Learn more by visiting https://www.pennsylvaniacin.com or by following us on LinkedIn, Twitter, Instagram and Facebook.
Genesis Medical Associates, Inc., is the largest independent primary care physician group serving the Greater North Hills with 11 offices stretching north from the city of Pittsburgh to Cranberry Township in Butler County.
Media Contact:
Bill Hayward for the PA Clinical Network
(717) 852-7171
bhayward@marketingworks.net
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SOURCE The PA Clinical Network
