2019-01-12 / Front Page

UPMC clarifies insurance issue

While Charles Cole Memorial Hospital anniversary in 2017, another historic development was in the works that would soon eclipse that milestone.

A merger with a large Pittsburgh-based health care resulted in the launch of UPMC Cole last March, making the local hospital part of the sprawling University of Pittsburgh Medical Center conglomerate.

Since the merger, rumors have flown freely about administrative changes, potential job losses and a myriad of other topics. Last week, UPMC Cole's local management issued a release designed to debunk one of the most widely circulated speculations.

I'd like to clarify a question that we hear often involving health insurance plans accepted at UPMC Cole," said president Ed Pitchford, a holdover from Cole's previous top management team. “We continue to accept many insurance plans, including Highmark Blue Cross Blue Shield, for all services, including cancer care.”

Pitchford said reports of changes due to take place in the greater Pittsburgh and Erie areas in July sparked local speculation.

“Most UPMC facilities and physicians in those areas will no longer be in-network, with a few exceptions related to specialized services,” he explained. “In this region, the UPMC hospitals in Coudersport, Wellsboro, Kane, and Jamestown, N.Y., will continue to be in-network for Highmark members after June 30.”

The hospital advised those seeking additional information on full, in-network access to UPMC doctors and hospitals to call 855-646-8762.

This year’s merger was part of a national consolidation trend in the industry driven by economics, growing power by insurance companies, and government policies. Unless a small provider has deep pockets or other means of financial support, the choices have been narrowed to two -- shut down or merge.

UPMC agreed to support Cole’s outstanding debts and make ongoing investments of at least $27.5 million over a period of seven years, including an information technology upgrade. Officials said the local hospital would save costs by purchasing drugs and medical supplies through UPMC contracts with suppliers.

UPMC Cole continues to be supported by its local board of directors and is now partnered with UPMC Susquehanna, based in Lycoming County.

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