What the UPMC Move to Central PA Means for Insurance Plans


February 1st, 2018

The University of Pittsburgh Medical Center is moving into the Central PA health insurance market by buying PinnacleHealth System, based in Harrisburg. The deal would give UPMC control over seven hospitals in the area, including:

  • Carlisle Regional Medical Center in Carlisle
  • Heart of Lancaster Regional Medical Center in Lititz
  • Lancaster Regional Medical Center in Lancaster
  • Memorial Hospital in York
  • PinnacleHealth West Shore Hospital in Mechanicsburg
  • PinnacleHealth Harrisburg Hospital in Harrisburg
  • PinnacleHealth Community General Osteopathic Hospital in Harrisburg

This change in Central PA health insurance and the health market is not unprecedented. Many smaller healthcare organizations across the state and nation create relationships with larger organizations and seek consolidation for better access to capital and more competitive healthcare staff recruitment.

 

How Will the UPMC Move Affect Health Insurance Plans in Central PA?

Central PA has long been dominated by Highmark Blueshield, the largest insurance carrier in the area. In addition, Capital BlueCross, Geisinger Health Plan, Aetna, United Health Care and other insurance carriers also serve clients in the area.  The UPMC arrangement with PinnacleHealth will allow UPMC to enter the health care insurance market in the region, although regulators will closely follow the company’s progress.

 

Since the UPMC deal includes hospitals, there is already a network of institutions and health providers for UMPC plans. Like Geisinger, UMPC is part of a current industry tendency to have health systems act as both health care provider and insurer, which can make it harder for patients to access care through other plans. Depending the plan selection, this could mean some patients won’t be able to choose which providers to visit. Doctors outside of the UPMC system, for example, may not be available to patients with UMPC care.

 

If you live in Central PA, the move can benefit you by providing you with another choice for insurance. If you’re already in an insurance program or use one of the hospitals affected by the agreement, your coverage may change. Geisinger Health System and other health care providers might not accept UMPC insurance, meaning patients who already work with providers in this network could find they need to find new specialists or solutions for their healthcare needs.

 

What Can I Do?

The UPMC move brings about heightened competition. When you work with Gunn-Mowery, you get the Upside of Insurance. Our team works to leverage competition in your favor, seeking out the best coverage at the best rates for you.

 

If you’re concerned about how these changes in the Central PA health market could impact your access to health plans, or if you’re an employer in the area and want to offer your employees the best coverage in this dynamic market, contact Gunn-Mowery, LLC. Our goal is to bring you real-world insurance solutions for your specific needs. We explain insurance in plain language and develop relationships with many insurance companies, so we can bring you the best coverage and quotes in this ever-changing industry.

 

For more information, download the LEG REG Review, published by Phillips Associates:

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