... And a Side of Lies | News | Pittsburgh | Pittsburgh City Paper

... And a Side of Lies

The Highmark/UPMC PR war opens up a new front: diners! Prepare for indigestion — and not from the meatloaf.


1) "Highmark needs 41,000 patient admissions to leave UPMC and community hospitals to go to theirs," this oddly knowledgeable diner patron tells us in a UPMC spot. Indeed, when the state Insurance Commissioner approved Highmark's acquisition of the ailing West Penn Allegheny Health System, its ruling said flatly that "for Highmark's ... strategy to work, it must incentivize patients to select [its] hospitals instead of UPMC."

2) "No wonder UPMC can't sign a contract with Highmark," says this patron, who appears surprised to learn Highmark even owns a hospital. (Hasn't he seen all the other ads?) As an earlier UPMC ad insists, "UPMC cannot sign a contract with Highmark that limits your access to UPMC." So UPMC has decided to limit access by not signing a contract instead — apparently to avoid future misunderstanding. That's a high-risk strategy for everyone: Financial statements show more than a quarter of UPMC's revenue comes from Highmark premiums.

3) As if to ensure these ads are inescapable, UPMC made headlines this week by suing Highmark for ... false advertising. UPMC says it's "misleading" for Highmark's ads to claim UPMC wants to kick out patients: Highmark subscribers will be admitted, UPMC says, though at higher, out-of-network rates. Ironically, UPMC's case relies on legal arguments Highmark used in a 2001 lawsuit against UPMC: Back then, "Highmark took the position ... that it was false to represent that out-of-network access was tantamount to no access," UPMC's suit says — exactly the case UPMC's making today. If UPMC and Highmark sound more like each other the longer this goes on, it's not your imagination.

4) As City Paper reported online last week, this ad was actually shot at a diner in Columbus, Ohio. But when you're planning an oncology center in Kazakhstan, maybe filming ads in Columbus makes sense.

1) "UPMC says it supports saving West Penn Allegheny Health System," grouses this diner in Highmark's ad. "Then Highmark saves West Penn Allegheny, and UPMC says in retaliation, ‘We won't sign a contract that allows Highmark health-insurance customers to use UPMC.'" Actually, UPMC's lawsuit points out, Highmark will still be accepted at some facilities, including Children's Hospital. But the irony remains: UPMC touts competition as the lifeblood of health care, and has said Highmark is the only entity in town that could save its ailing competitor, West Penn. But now that the patient is receiving a financial transfusion, UPMC wants to pull the plug on the donor. 

2) Letting customers pick their insurer and doctor is "exactly what Highmark's doing," says this chef. "They're even willing to take UPMC insurance!" But while Highmark might want UPMC in its network, customers might pay a premium to use it: Insurance companies use "tiering" — charging different rates at different facilities — to push customers toward preferred providers. UPMC worries that we, like this short-order cook, might sign up with Highmark without realizing the strings attached. (Though if we're all free to choose our insurer — as both these ads suggest — couldn't customers simply drop Highmark over such tactics?)

3) Ironically, these geezers might have the least to lose in the Highmark/UPMC battle (another gripe in the UPMC lawsuit). Seniors covered by Medicare will be able to stick with the doctors they've got no matter what. Those of us in the private insurance market have less recourse, though that may change. In Harrisburg, state Reps. Dan Frankel (D-Squirrel Hill) and Jim Christiana (R-Beaver) are drumming up support for a bill requiring UPMC to contract with Highmark — like it or not.

4) Highmark filmed its ad at Kelly O's in the Strip District, with Heinz ketchup bottles and other Pittsburgh cues scattered about. So at least somebody in Pittsburgh is benefiting from all this. 

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