Allegheny Health Network administrators Thursday lobbied for the right of every patient to see any doctor, regardless of the patient’s insurance card.
Hospital administrators backed the legislative change necessary to provide such access, even though it would likely slow the system’s return to fiscal viability as Highmark Inc. members choose UPMC doctors and hospitals, said Jefferson Regional Medical Center President and CEO John Dempster.
“This is a clear message to our patients,” Dempster said. “You’re in charge.”
The bill would curb the “inappropriate use of market power” to control consumer choice of health care providers, he said.
AHN administrators and doctors held a news conference to back the necessary legislative change as the General Assembly prepares to return to Harrisburg. If enacted, a bill prohibiting health care systems from refusing to contract with an insurer would end the need for a contract between Highmark and hospital giant UPMC, a legislative solution to a thorny problem.
Allegheny General Hospital Interim President and CEO Judy Zedreck said passage of such a bill was now a real possibility. “We have a lot of indication there is movement,” Zedreck said.
Some states have achieved AHN’s open access goals by enacting any willing provider legislation, which requires insurers to contract with medical providers who meet the terms and conditions of the carrier. Insurers create provider networks by contracting with doctors, hospitals and other health care providers with the promise of patient volume in return for lower costs.
Without a contract with UPMC, Highmark faces the prospect of being a limited access network insurer, costing the carrier its longtime market dominance. UPMC has said it will not renew the Highmark contract when it expires in 2014.
“Such a contract would instantly extinguish insurance competition and provider competition and restore the double-digit premium increases, which have plagued this community, kept wages down and stalled job growth,” UPMC spokesman Paul Wood said in a prepared statement. “Any sort of ‘any willing’ legislative proposal is anything but willing – it’s coercion.”