By Paul
Barr | March 27, 2018
UPMC is still quietly fighting to end its relationship with
Highmark Health's Medicare Advantage program in Pennsylvania.
Although the UPMC health system and Highmark previously had settled another dispute, UPMC's just-released financial statements for Dec. 31 noted that it appealed a state ruling requiring it to accept Highmark Medicare Advantage patients beyond the expiration of a consent decree in June 2019.
Pennsylvania's Supreme Court will hear arguments for the case in May, according to the case docket.
"We are confident that the Pennsylvania Supreme Court will be persuaded by Judge Pellegrini's decision supporting in-network access to UPMC hospitals in Pittsburgh and Erie through 2019 for Highmark Medicare Advantage Security Blue and Freedom Blue members and will affirm," a Highmark spokesperson said in an email.
Representatives of UPMC couldn't be reached for comment.
The two organizations are moving more into each other's traditional lines of business, with UPMC's net patient revenue not that much greater than its health insurance revenue, and Blues affiliate Highmark owning its own health system, eight-hospital Allegheny Health Network.
For the six months ended Dec. 31, UPMC reported net patient service revenue less bad debt of $3.9 billion, and insurance enrollment revenue of $3.6 billion.
Meanwhile, in the same six-month period in 2017, UPMC's profit on its unrestricted net assets was $892 million (excluding $44 million in other changes to unrestricted net assets). The profit was bolstered by investment and financing gains of $146 million.
Operating income totaled $111 million on operating revenue of $8.12 billion, producing an operating margin of 1.4%.
UPMC is converting to a Dec. 31 year-end from June 30 beginning in 2018.
Correction: UPMC and Highmark had not earlier indicated the dispute was resolved. Also UMPC does compare its financial results results to previous years in the latest report, as it converts to a new fiscal year.
Although the UPMC health system and Highmark previously had settled another dispute, UPMC's just-released financial statements for Dec. 31 noted that it appealed a state ruling requiring it to accept Highmark Medicare Advantage patients beyond the expiration of a consent decree in June 2019.
Pennsylvania's Supreme Court will hear arguments for the case in May, according to the case docket.
"We are confident that the Pennsylvania Supreme Court will be persuaded by Judge Pellegrini's decision supporting in-network access to UPMC hospitals in Pittsburgh and Erie through 2019 for Highmark Medicare Advantage Security Blue and Freedom Blue members and will affirm," a Highmark spokesperson said in an email.
Representatives of UPMC couldn't be reached for comment.
The two organizations are moving more into each other's traditional lines of business, with UPMC's net patient revenue not that much greater than its health insurance revenue, and Blues affiliate Highmark owning its own health system, eight-hospital Allegheny Health Network.
For the six months ended Dec. 31, UPMC reported net patient service revenue less bad debt of $3.9 billion, and insurance enrollment revenue of $3.6 billion.
Meanwhile, in the same six-month period in 2017, UPMC's profit on its unrestricted net assets was $892 million (excluding $44 million in other changes to unrestricted net assets). The profit was bolstered by investment and financing gains of $146 million.
Operating income totaled $111 million on operating revenue of $8.12 billion, producing an operating margin of 1.4%.
UPMC is converting to a Dec. 31 year-end from June 30 beginning in 2018.
Correction: UPMC and Highmark had not earlier indicated the dispute was resolved. Also UMPC does compare its financial results results to previous years in the latest report, as it converts to a new fiscal year.
Paul Barr, a healthcare journalist since 2004,
is responsible for Modern Healthcare’s feature stories. Barr most recently was
a senior editor for Hospitals & Health Networks, but before that worked six
years at Modern Healthcare as news editor and two years as a reporter. In 2016
he won a Jesse H. Neal award for best single story, and in 2015 was a finalist
for best series. Prior to 2004, he covered financial matters for various
publications. Barr has a bachelor’s degree in economics and master’s degrees in
journalism and business from the University of Illinois.
No comments:
Post a Comment