UPMC Health Plan

Colonials to host Ontario Tech at Johnstown’s 1st Summit Arena at Cambria County War Memorial | 9/12/2019

… an exhibition game against the Ontario Tech Ridgebacks at the historic 1st Summit Arena at Cambria County War Memorial in Johnstown, PA on January 4, 2020. Titled the 2020 Co llege Classic, presented by UPMC Health Plan , the event will mark the first game between NCAA Division-I college-level teams in the arena’s 69-year history. Home of the North American Hockey League’s (NAHL) Johnstown Tomahawks, the 1st Summit …

Maxor’s Chief Pharmacy Officer, Michael Einodshofer, Named 2019-2020 President-Elect of National Association of Specialty Pharmacy | PR Newswire | 9/11/2019

… started his 20+ year pharmacy career practicing pharmacy in both retail and hospital pharmacy settings before transitioning to the managed care industry in 2006. His past roles include the Director of Pharmacy Operations for UPMC Health Plan and the Senior Director for Specialty Strategy and Innovation at Walgreens Boots Alliance. Michael has been on the executive leadership team at Maxor since August 2016 . Mike Ellis , Maxor’s Chief Executive Officer, says …

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Great Allegheny Passage Trail Relay Presented By UPMC Health Plan Aims To Be First Carbon Neutral Trail Relay In U.S. | 9/10/2019

P3R-Pittsburgh Marathon has partnered with the Allegheny Trail Alliance and the PA Environmental Council to host the first carbon neutral trail relay event in the U.S. at this year’s Great Allegheny Passage Relay presented by UPMC Health Plan , scheduled for Oct. 11-12. “The GAP Relay showcases some of the best natural beauty in Pennsylvania and Maryland, and we want to do everything we can to reduce the event’s carbon …

Royals Renew Affiliation Partnership with Philadelphia Flyers | 9/9/2019

The Reading Royals announced Monday the team has agreed to a one-year extension with a second-year option to serve as ECHL affiliate of the Philadelphia Flyers and Lehigh Valley Phantoms. The 2019-20 season, presented by Tower Health and UPMC Health Plan, marks the sixth straight that the Royals have been affiliated with the Flyers and Phantoms. Reading has qualified for the playoffs in four of the first five …

(USA-PA-Pittsburgh) Operations Analyst, Intermediate | 9/7/2019

… the U.S. Steel Tower. The Operations Analyst, Intermediate, will oversee administrative, system processes and special project as they relate to identification, implementation and maintenance of the claims transactional system and other applications for all UPMC Health Plan products. Under the general direction of the Business Support Management team, this role will analyze, identify, propose and implement solutions for all business areas. He/she will act as subject matter expert supporting …

(USA-PA-Pittsburgh) Sr. UX Designer | 9/7/2019

UPMC Sr. UX Designer in Pittsburgh , Pennsylvania Description UPMC Health Plan has an exciting opportunity for a Sr. UX Designer in its Consumer Innovation department, located in downtown Pittsburgh at the Heinz 57 Center. As a UX Designer at UPMC Health Plan, you’re a problem-solver, working to discover, investigate and understand complicated health insurance issues. To improve the experience and healthcare journey of our members, you will collaborate with …

(USA-PA-Pittsburgh) Operations Analyst, Lead | 9/7/2019

UPMC Operations Analyst, Lead in Pittsburgh , Pennsylvania Description Purpose: UPMC Health Plan’s Medicare Compliance Department is seeking an Operations Analyst, Lead! This role oversees administrative and system processes as they relate to implementation and maintenance of the claims transactional system in additional to other applications for all UPMC Health Plan products. Under the general direction of the Business Support Management team, this role will analyze, identify, propose and implement solutions …

(USA-PA-Pittsburgh) Manager Medicare Compliance | 9/7/2019

UPMC Manager Medicare Compliance in Pittsburgh , Pennsylvania Description Purpose: UPMC Health Plan is seeking a LIMITED/CASUAL Manager, Medicare Compliance. Under the general direction of the Director, Medicare, the Manager, Medicare Compliance will be responsible for managing the Medicare compliance department, including communicating compliance issues within UPMC Health Plan, communicating with CMS, assisting with CMS audits. Responsibilities: Respond to requests from OIG, CMS attestations, etc. by due date and maintain …

UPMC Health Plan signs on as YMCA Turkey Trot sponsor | TribLIVE.com | 9/6/2019

… YMCA Turkey Trot, set for 7 a.m. to noon Nov. 28 outside PNC Park. Register for the 29th annual trot at active.com in one of four races: MedExpress 1-Mile Family Fun Run/Walk, UPMC Health Plan 5K Turkey Trot, the 5-mile run and Gentile, Horoho & Avalli, P.C. Double Gobble (5K plus 5-mile). Participants also will be helping to support YMCA food pantry programs and the Greater Pittsburgh …

Insurance Providers Launch New Payment Model to Save Rural Hospitals in Pennsylvania | 9/5/2019

… the rate of closure is faster than at any other time and raises great concerns for these residents, even triggering a Congressional hearing in March 2019. Highmark , Gateway Health , Geisinger Health Plan , Medicare , and UPMC Health Plan participate in the Pennsylvania Rural Health Model – an innovative project launched in January 2019 to buoy the finances of rural hospitals in the Commonwealth. In this project, spearheaded by the Pennsylvania Department of …

People on the Move – September 3, 2019 | 9/3/2019

… on the Move – September 3, 2019 Posted on September 3, 2019 by Medical Dealer Staff By Matt Skoufalos Sheryl Kashuba , chief legal officer and SVP of regulatory affairs, health policy, and government relations at UPMC Health Plan , has been appointed to the new Pennsylvania Health Insurance Exchange Authority . eHealth, Inc. of Santa Clara, California named Beth A. Brooke to its Board of Directors. Brooke was Global Vice Chair of Public …

Governor Appoints UPMC Health Plan Leader to Insurance Exchange Authority | PR Newswire | 8/30/2019

PITTSBURGH , Aug. 30, Gov. Tom Wolf has appointed Sheryl Kashuba , chief legal officer and senior vice president of regulatory affairs, health policy, and government relations at UPMC Health Plan, to the new Pennsylvania Health Insurance Exchange Authority. The Authority will work with Commissioner Jessica Altman and the Pennsylvania Insurance Department to help establish the state’s new state-based health insurance exchange in 2021, as set forth in recently enacted legislation …

Medicare Advantage Start-Ups Primed To Disrupt The Status Quo, Warns Cavulus CEO | PR Newswire | 8/28/2019

PITTSBURGH , Aug. 28, The ranks of Medicare Advantage (MA) Plans are growing not only in number, but also in sophistication, observes Patrick Phillips , CEO of Cavulus, a leading technology firm that serves the MA industry. Phillips says 14 new Medicare Advantage organizations are entering the highly competitive, Medicare Advantage market this Fall as the Annual Election Period begins in October. “Many new plans are created by groups which have a …

UPMC doctors ready to meet ‘pent-up demand’ after inking 10-year contract with Highmark | TribLIVE.com | 8/28/2019

UPMC facilities are preparing to meet the “pent-up demand” among Highmark-insured patients who now can choose to go to UPMC doctors and hospitals, particularly when it comes to specialty care, UPMC’s chief financial officer said Tuesday. “We’re seeing (patient) volume increases,” said Robert DeMichiei, CFO of UPMC, a nonprofit health system based in Downtown Pittsburgh’s U.S. Steel Tower that, like its rival Highmark, controls both provider and insurer …

Multiple sclerosis drug costs skyrocketed for Medicare and patients, study finds | 8/27/2019

First published on Dive Brief: Multiple sclerosis patients acutely felt the impact of rising list prices for their medications, according to research published Monday in JAMA that found typical Medicare out-of-pocket costs ballooned from $372 to $2,673 over a decade. Between 2006 and 2016, average list prices more than quadrupled from less than $20,000 a year to slightly more than $75,000. The study’s authors, a group from the …

(USA-PA-Pittsburgh) Health Manager - Special Needs Program | 8/24/2019

… licensed health/human services professional with at least five years of experience in behavioral health clinical, care coordination, and/or case management? Do you have experience working in a managed care environment? If so, UPMC Health Plan may have the perfect fit for you! UPMC Health Plan is hiring a full-time Health Manager to support the Medical Management Special Needs Plan department. This position is a daylight role (8:00 …

Heritage Valley Beaver named Center of Excellence for knee and hip replacement | 8/19/2019

… a Center of Excellence will have a navigator or nurse to help facilitate the surgical experience, said Dr. MaCalus Hogan, vice-chair of orthopedic surgery at UPMC Medical Center and co-chair of the UPMC Health Plan Center of Excellence Program. “The program ensures that you have a surgeon who is really following best practices that have been defined nationally,” Hogan said. “These physicians are fellowship-trained in joint replacement …

(USA-PA-Erie) Erie Customer Service Representative - Temporary | 8/18/2019

UPMC Erie Customer Service Representative - Temporary in Erie , Pennsylvania Description The UPMC Health Plan Member Services Team is currently hiring temporary Customer Service Representatives in Erie, PA to be advocates for our members and to proudly wear the badge of UPMC Health Plan during the open enrollment period. With a close-knit work environment and a dedicated culture of service excellence, our Member Services Team educates and guides our customers …

(USA-PA-Erie) Erie Customer Service Career Fair for Temporary Roles - August 29th | 8/18/2019

UPMC Erie Customer Service Career Fair for Temporary Roles - August 29th in Erie , Pennsylvania Description Are you looking to jumpstart a career that offers personal development and plenty of room for growth? If so, UPMC Health Plan is currently seeking star candidates for temporary customer service roles! Join us at our career fair event on Thursday, August 29th at the Erie Operations Center (380 E Bayfront Parkway, Erie, PA 16507 …

(USA-PA-Pittsburgh) Claims Examiner | 8/18/2019

UPMC Claims Examiner in Pittsburgh , Pennsylvania Description At UPMC, we’re exceeding production and quality of designated standards for claims processing, and we want you to join our team! UPMC Health Plan is currently seeking full-time Claims Examiner positions at our two locations. These positions will be at the US Steel Tower and our Harbor Gardens Locations. As a key member of our team, you will manage adjudication of moderate …

Medicare

Governor Appoints UPMC Health Plan Leader to Insurance Exchange Authority | PR Newswire | 8/30/2019

… has appointed Sheryl Kashuba , chief legal officer and senior vice president of regulatory affairs, health policy, and government relations at UPMC Health Plan, to the new Pennsylvania Health Insurance Exchange Authority. The Authority will work … Behavioral Health — offers a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health, employee assistance and workers’ compensation products and services to 3.5 million members. For more information, visit www.upmchealthplan.com …

Anthem, Humana along with Apple and Google testing API for patient access to claims data | FierceHealthcare | 8/3/2019

While announcements from the Centers for Medicare and Medicaid Services and major tech giants took center stage at the Blue Button Developers Conference on Tuesday, there was another initiative announced that could potentially have huge … include California health information exchange Manifest MedEx, Microsoft, Pittsburgh-based UPMC Health Plan, Marshfield Clinic Health System-Security Health Plan, Prominence Health Plan and the states of North Carolina and Washington. The data model and

Medicaid

Anthem, Humana along with Apple and Google testing API for patient access to claims data | FierceHealthcare | 8/3/2019

While announcements from the Centers for Medicare and Medicaid Services and major tech giants took center stage at the Blue Button Developers Conference on Tuesday, there was another initiative announced that could potentially have huge … include California health information exchange Manifest MedEx, Microsoft, Pittsburgh-based UPMC Health Plan, Marshfield Clinic Health System-Security Health Plan, Prominence Health Plan and the states of North Carolina and Washington. The data model and

Medicare Advantage

Medicare Advantage Offers Clues to Untangling the “Medicare for All” Dilemma | PR Newswire | 7/9/2019

… watch Congress debate universal health care, according to Patrick Phillips , CEO of Cavulus. Cavulus is a technology firm specializing in Medicare Advantage solutions. Already in the 116 th Congress more than 10 bills addressing “Medicare … some of America’s top insurers, including several BlueCross/ BlueShield companies, UPMC Health Plan, SCAN Health Plan, John Hopkins Healthcare, Lumeris and United Healthcare. For details: visit www.cavulus.com . Media Inquiries 1-800-760-6915 Email: [email protected] SOURCE Cavulus …

UPMC backpedals on controversial prepayment policy | Becker’s Hospital Review | 6/6/2019

UPMC backpedals on controversial prepayment policy Morgan Haefner - Print Email UPMC no longer plans to require patients with Medicare Advantage coverage through Highmark to pay for services in advance once consent decrees between the Pittsburgh … network emergency services from Highmark at the same rate that UPMC Health Plan pays Pittsburgh-based Allegheny Health Network hospitals, which are part of Highmark.On June 4, the Pittsburgh Post-Gazette reported federal officials were

Behavioral Health

Governor Appoints UPMC Health Plan Leader to Insurance Exchange Authority | PR Newswire | 8/30/2019

… has appointed Sheryl Kashuba , chief legal officer and senior vice president of regulatory affairs, health policy, and government relations at UPMC Health Plan, to the new Pennsylvania Health Insurance Exchange Authority. The Authority will work … Life , UPMC for You , UPMC for Kids, and Community Care Behavioral Health — offers a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health, employee assistance and workers’ compensation products and …

Social Determinants of Health, APMs Coming Up at AHIP Institute | RevCycle Intelligence | 6/19/2019

UPMC Health Plan, and the National Patient Advocate Foundation will cover patient engagement in APM development. HCP-LAN will take the stage on June 20 to share their roadmap for designing and implementing high-performing APMs. Following their presentation, representatives from leading payer organizations will explore the role of electronic prescribing and behavioral health in APMs in two separate panels. On the final day of AHIP Institute 2019, leaders from …

ACA

UPMC Health Plan forms Center of Excellence for hip, knee replacement surgery | FierceHealthcare | 8/8/2019

UPMC Health Plan has designated nine providers as members of its new Center of Excellence for hip and knee replacement surgery. The included providers have high patient satisfaction, high-quality outcomes and few complications in … great surgeons and clinical and operational leaders across UPMC,” said MaCalus V. Hogan, M.D., vice chair of orthopedic surgery at the health system, in a statement

Medicare Advantage Offers Clues to Untangling the “Medicare for All” Dilemma | PR Newswire | 7/9/2019

… voluntarily switch plans on an annual basis compared to a 40% churn for adults enrolled under the Affordable Care Act (ACA). “The attractiveness of Medicare Advantage is understandable given the robust medical and prescription drug … some of America’s top insurers, including several BlueCross/ BlueShield companies, UPMC Health Plan, SCAN Health Plan, John Hopkins Healthcare, Lumeris and United Healthcare. For details: visit www.cavulus.com . Media Inquiries 1-800-760-6915 Email: [email protected] SOURCE Cavulus …

Kaiser Family Foundation

Medicare Advantage Offers Clues to Untangling the “Medicare for All” Dilemma | PR Newswire | 7/9/2019

… Advantage is understandable given the robust medical and prescription drug coverage offered at competitive and predictable prices,” asserts Phillips, noting Kaiser Family Foundation studies showing these prices to range from $26 per month for HMO … some of America’s top insurers, including several BlueCross/ BlueShield companies, UPMC Health Plan, SCAN Health Plan, John Hopkins Healthcare, Lumeris and United Healthcare. For details: visit www.cavulus.com . Media Inquiries 1-800-760-6915 Email: [email protected] SOURCE Cavulus …

Social Determinants of Health, APMs Coming Up at AHIP Institute | RevCycle Intelligence | 6/19/2019

… utilization and inappropriate care by incorporating appropriate use measures into alternative payment models. Later that day, leaders from Fallon Health, UPMC Health Plan, and the National Patient Advocate Foundation will cover patient engagement in APM … under high-deductible health plans, according to data from the Kaiser Family Foundation. With increased financial responsibility, healthcare consumers are expecting more from their providers and payers. Consumers expect a retail-like experience from healthcare …

AMA

Obamacare sign-ups expected to lag at the end of enrollment this week - POLITICO | 12/1/2017

Obamacare’s open-enrollment season is headed for a disappointing ending this Friday despite its surprisingly robust start. The reasons for the expected lag include the Trump administration’s decision to cut the sign-up period in … director Elizabeth Colvin. “Our funding is completely local.” Pittsburgh-based UPMC Health Plan also says it has increased communications with its Obamacare customers due to uncertainty about the law. The insurer’s simple message: Call us

Obamacare premiums were stabilizing. Then Trump happened. | MSN | 10/18/2017

Obamacare premiums were stabilizing. Then Trump happened. Vox.com 26 mins ago Dylan Scott © Provided by Vox.com Back in May, the UPMC Health Plan in Pennsylvania said it would need to increase its health insurance premiums on the Affordable Care Act’s marketplace by 8 percent, on average, in 2018. It was an entirely unremarkable number that would allow the plan to cover the expected increase in health care costs and account …

Mental Health

UPMC Center for High-Value Health Care Partners with Pennsylvania Department of Drug and Alcohol Programs on SAMHSA Grant | PR Newswire | 12/20/2017

… administration of a $5,700,000 grant from the Pennsylvania Department of Drug and Alcohol Programs (DDAP) from the Substance Abuse and Mental Health Services Administration (SAMHSA). The grant will expand, enhance, and evaluate access to medication … in Pittsburgh, Pa. The UPMC Insurance Services Division – which includes UPMC Health Plan, WorkPartners, UPMC for Life , UPMC for You , UPMC for Kids, and Community Care Behavioral Health — offers a full range of group health …

Health Insurance Marketplace

UPMC Health Plan Offers the Lowest Cost Silver Marketplace Plans For the Fourth Consecutive Year | PR Newswire | 10/31/2017

PITTSBURGH , Oct. 31, UPMC Health Plan will once again offer the lowest cost health insurance plans on Pennsylvania’s Health Insurance Marketplace, including the lowest cost Silver option in 32 Pennsylvania counties where UPMC Health Plan offers individual coverage. UPMC Health Plan also offers some of the lowest cost individual plans outside of the Marketplace. “For 2018, we look forward to enrolling many new Marketplace customers who will join the over …

Department of Health and Human Services

UPMC Center for High-Value Health Care Partners with Pennsylvania Department of Drug and Alcohol Programs on SAMHSA Grant | PR Newswire | 12/20/2017

… in these communities and improved care for those in need of these services.” SAMHSA is a branch of the U.S. Department of Health and Human Services and is responsible for improving the quality and availability … in Pittsburgh, Pa. The UPMC Insurance Services Division – which includes UPMC Health Plan, WorkPartners, UPMC for Life , UPMC for You , UPMC for Kids, and Community Care Behavioral Health — offers a full range of group health …

UnitedHealth

How UPMC-Highmark deal could rewrite the regions’ insurance playbook | The Business Journals | 6/25/2019

UPMC Health Plan, at the same time, has increased 10.6 percent. And there have been double-digit gains for national insurers Aetna, Cigna and UnitedHealthcare. Moody’s Investors Service said the 10-year contract between UPMC and Highmark is a “credit positive” for Highmark — and could help it regain membership lost during the years-long conflict with UPMC. “We view it as a positive for enrollment,” said Stefan Kahandaliyanage , a Moody’s …

Employers throughout Pittsburgh feel sense of relief as UPMC, Highmark reach deal | The Business Journals | 6/24/2019

… accessing.” According to Shapiro, under the agreement, Highmark members will have in-network access to all UPMC doctors and hospitals. UPMC Health Plan, on the other hand, will get access to some but not all … he said. “We had gone to a third-party payer, UnitedHealthcare , simply so our employees would be able to have access to both systems.” The UPMC/Highmark agreement makes IKM’s business choices “come renewal time …

Apple Health

UPMC Health Plan forms Center of Excellence for hip, knee replacement surgery | FierceHealthcare | 8/8/2019

UPMC Health Plan has designated nine providers as members of its new Center of Excellence for hip and knee replacement surgery. The included providers have high patient satisfaction, high-quality outcomes and few complications in surgery, the insurer announced . The goal, UPMC said, is to help connect patients with providers that offer the best care. The Pittsburgh, Pennsylvania-based payer said in the announcement that to choose the Center of …

Anthem, Humana along with Apple and Google testing API for patient access to claims data | FierceHealthcare | 8/3/2019

While announcements from the Centers for Medicare and Medicaid Services and major tech giants took center stage at the Blue Button Developers Conference on Tuesday, there was another initiative announced that could potentially have huge implications for patients getting easier access to their claims data. The Carin Alliance , a private sector collaboration made up of major health insurers, providers, health IT companies and tech giants, announced at the conference that …

Microsoft Health

Anthem, Humana along with Apple and Google testing API for patient access to claims data | FierceHealthcare | 8/3/2019

While announcements from the Centers for Medicare and Medicaid Services and major tech giants took center stage at the Blue Button Developers Conference on Tuesday, there was another initiative announced that could potentially have huge implications for patients getting easier access to their claims data. The Carin Alliance , a private sector collaboration made up of major health insurers, providers, health IT companies and tech giants, announced at the conference that …

Cambia Health Solutions

Anthem, Humana along with Apple and Google testing API for patient access to claims data | FierceHealthcare | 8/3/2019

… to their historical claims information through an app of their choice. Twenty organizations—including Apple, Anthem, Blue Cross Blue Shield, Cambia Health Solutions, Google, and Humana—have agreed to perform “real-world testing” of the … include California health information exchange Manifest MedEx, Microsoft, Pittsburgh-based UPMC Health Plan, Marshfield Clinic Health System-Security Health Plan, Prominence Health Plan and the states of North Carolina and Washington. The data model and …

HCA

UPMC Health Plan forms Center of Excellence for hip, knee replacement surgery | FierceHealthcare | 8/8/2019

UPMC Health Plan has designated nine providers as members of its new Center of Excellence for hip and knee replacement surgery. The included providers have high patient satisfaction, high-quality outcomes and few complications in … Helwig, M.D., chief quality officer for the health plan, told FierceHealthcare that part of what spurred the launch of the center was demand from employers, particularly as orthopedic surgeries are common. “There is a very

University of Pittsburgh Medical Center

UPMC Health Plan Maintains A- (Excellent) Rating from A.M. Best | PR Newswire | 12/27/2017

UPMC Health Plan Maintains A- (Excellent) Rating from A.M. Best WorkPartners’ (UPMC Workers’ Compensation Group) also earns A- (Excellent) Rating News provided by 14:18 PITTSBURGH , Dec. 27, UPMC Health Plan has retained its financial strength … Division The UPMC Insurance Services Division is owned by UPMC ( University of Pittsburgh Medical Center) a world-renowned health care provider and insurer based in Pittsburgh, Pa. The UPMC Insurance Services Division – which includes UPMC

University of Pittsburgh Medical Center, Pittsburgh PA

UPMC Health Plan Maintains A- (Excellent) Rating from A.M. Best | PR Newswire | 12/27/2017

UPMC Health Plan Maintains A- (Excellent) Rating from A.M. Best WorkPartners’ (UPMC Workers’ Compensation Group) also earns A- (Excellent) Rating News provided by 14:18 PITTSBURGH , Dec. 27, UPMC Health Plan has retained its financial strength rating of A- (Excellent) with a stable outlook from A.M. Best, the world’s oldest and most authoritative insurance rating and information source. The A- (Excellent) rating with a stable outlook applies to UPMC Health Insurance …

Allegheny Health Network

Employers throughout Pittsburgh feel sense of relief as UPMC, Highmark reach deal | The Business Journals | 6/24/2019

UPMC Health Plan, on the other hand, will get access to some but not all of the Highmark-owned Allegheny Health Network. The in-network will be Jefferson Hospital in the South Hills and Saint Vincent Hospital in Erie, but not West Penn Hospital and Allegheny General Hospital in Pittsburgh, according to UPMC. Highmark subscribers will get in-network access to UPMC Children’s Hospital of Pittsburgh, UPMC Hillman Cancer Center …

Pennsylvania AG says legal fight against UPMC far from over | Becker’s Hospital Review | 6/10/2019

UPMC Health Plan pays Pittsburgh-based Allegheny Health Network hospitals, which are part of Highmark. Still, Attorney General Josh Shapiro, whose office is taking legal action against UPMC over patient access, said the change won’t sway upcoming court proceedings.”Everyone should know we are not going away, no matter what happens in court. There are serious questions swirling around UPMC’s conduct that need to be answered through this litigation process …

Kaiser Permanente

Trump's opioid commission turns to the role of health insurers in addiction crisis | 10/20/2017

Kaiser Permanente, UnitedHealth Group and UPMC Health Plan. Rep. Elijah Cummings, the ranking member of the House Oversight Committee, also has questions for many of those same companies. He’s following up on a report by The New York Times last month that insurance companies “erected more hurdles to approving addiction treatments than for the addictive substances themselves.” “This is not a hypothetical problem,” Cummings wrote in letters to seven insurance …

Fourth Meeting of the President’s Commission on Combating Drug Addiction and the Opioid Crisis Convenes Today | PRWeb | 10/20/2017

Kaiser Permanente) Dr. Richard Migliori, executive VP & chief medical officer, UnitedHealth Group Diane Holder, president & CEO, UPMC Health Plan WHEN: Friday, October 20, 2017 from 11 a.m. – 1 p.m. EDT WHERE: The Eisenhower Executive Office Building 1650 Pennsylvania Ave. N.W. Washington, D.C. 20502 About The Kennedy Forum Founded in 2013 by former Congressman Patrick J. Kennedy (D-R.I.), The Kennedy Forum focuses on advancing evidence-based practices, policies, and programming …

Providence Health

U.S. News & World Report Announces the 2018 Best Medicare Plans | PR Newswire | 10/16/2017

Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This year, 15 of the 17 plans on the Medicare Part D Honor Roll are Blue Cross Blue Shield plans. U.S. News used plan-ratings data from the Centers for Medicare & Medicaid Services (CMS) to identify the Best Medicare Advantage …

U.S. News & World Report Announces The 2018 Best Medicare Plans - TheStreet | 10/16/2017

Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This year, 15 of the 17 plans on the Medicare Part D Honor Roll are Blue Cross Blue Shield plans. U.S. News used plan-ratings data from the Centers for Medicare & Medicaid Services (CMS) to identify the Best Medicare Advantage …

Highmark Health

The PA Clinical Network Responds to the UPMC-Highmark Consent Decree Decision | PR Newswire | 6/19/2019

… Highmark health insurance may no longer have automatic access to the UPMC provider network. “As a result of this ruling, a major Pennsylvania healthcare market is effectively being cleaved into two camps, which forces patients and physicians to choose participating in closed and exclusionary networks on the basis of opaque insurance economics—not what is in the best interest of UPMC Health Plan’s and Highmark’s members,” says Jaan Sidorov , MD …

The Advanced Leadership Initiative Announces New Corporate CEO Council: 15 CEOs Committed to Advancing African American Executive Leadership | PR Newswire | 5/9/2019

… Packaging Systems; Evan Frazier, Founding Director of the Advanced Leadership Initiative (TALI) and Senior Vice President of Community Affairs for Highmark Health; David Holmberg, President and CEO — Highmark Health; Mark S. Lewis, President & Chief Executive … President and CEO — Gateway Health Diane Holder , President and CEO — UPMC Health Plan David Holmberg , President and CEO — Highmark Health Laura Karet , President and CEO — Giant Eagle Jerry MacCleary , Chairman and CEO — Covestro Bob McDonald …

Health Net

Employers throughout Pittsburgh feel sense of relief as UPMC, Highmark reach deal | The Business Journals | 6/24/2019

UPMC Health Plan, on the other hand, will get access to some but not all of the Highmark-owned Allegheny Health Network. The in-network will be Jefferson Hospital in the South Hills and Saint Vincent Hospital in Erie, but not West Penn Hospital and Allegheny General Hospital in Pittsburgh, according to UPMC. Highmark subscribers will get in-network access to UPMC Children’s Hospital of Pittsburgh, UPMC Hillman Cancer Center …

Pennsylvania AG says legal fight against UPMC far from over | Becker’s Hospital Review | 6/10/2019

UPMC Health Plan pays Pittsburgh-based Allegheny Health Network hospitals, which are part of Highmark. Still, Attorney General Josh Shapiro, whose office is taking legal action against UPMC over patient access, said the change won’t sway upcoming court proceedings.”Everyone should know we are not going away, no matter what happens in court. There are serious questions swirling around UPMC’s conduct that need to be answered through this litigation process …

Cigna

How UPMC-Highmark deal could rewrite the regions’ insurance playbook | The Business Journals | 6/25/2019

UPMC Health Plan, at the same time, has increased 10.6 percent. And there have been double-digit gains for national insurers Aetna, Cigna and UnitedHealthcare. Moody’s Investors Service said the 10-year contract between UPMC and Highmark is a “credit positive” for Highmark — and could help it regain membership lost during the years-long conflict with UPMC. “We view it as a positive for enrollment,” said Stefan Kahandaliyanage , a Moody’s …

Social Determinants of Health, APMs Coming Up at AHIP Institute | RevCycle Intelligence | 6/19/2019

… healthcare are currently heading into the Music City to hear some of the most influential payers and industry experts, including Cigna Corporation’s president and CEO David M. Cordani, Merck’s chairman and CEO Kenneth C. Frazier … alternative payment models. Later that day, leaders from Fallon Health, UPMC Health Plan, and the National Patient Advocate Foundation will cover patient engagement in APM development. HCP-LAN will take the stage on June 20 …

Molina Healthcare

Obamacare premiums were stabilizing. Then Trump happened. | MSN | 10/18/2017

… Obamacare premiums were stabilizing. Then Trump happened. Vox.com 26 mins ago Dylan Scott © Provided by Vox.com Back in May, the UPMC Health Plan in Pennsylvania said it would need to increase its health insurance premiums … phenomenon is ridiculous,” said Mario Molina, the former CEO of Molina Healthcare, a big player in the market. “This is Donald Trump monkeying around with health insurance, which is something he doesn’t understand.” Obamacare was …

Humana

UPMC Health Plan forms Center of Excellence for hip, knee replacement surgery | FierceHealthcare | 8/8/2019

UPMC Health Plan has designated nine providers as members of its new Center of Excellence for hip and knee replacement surgery. The included providers have high patient satisfaction, high-quality outcomes and few complications in … Hospital UPMC St. Margaret UPMC Passavant UPMC Shadyside RELATED: Anthem, Humana along with Apple and Google testing API for patient access to claims data UPMC Health Plan said that it will accept additional applications for

Anthem, Humana along with Apple and Google testing API for patient access to claims data | FierceHealthcare | 8/3/2019

… through an app of their choice. Twenty organizations—including Apple, Anthem, Blue Cross Blue Shield, Cambia Health Solutions, Google, and Humana—have agreed to perform “real-world testing” of the API to prepare for a … include California health information exchange Manifest MedEx, Microsoft, Pittsburgh-based UPMC Health Plan, Marshfield Clinic Health System-Security Health Plan, Prominence Health Plan and the states of North Carolina and Washington. The data model and …

Essence Healthcare

U.S. News & World Report Announces the 2018 Best Medicare Plans | PR Newswire | 10/16/2017

Essence Healthcare, Health Alliance Medicare, Health Partners, Kaiser Permanente, Martin’s Point Generations Advantage, Medica Insurance Company, MVP HEALTH CARE, Paramount Elite, Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This year, 15 of the 17 plans on the Medicare Part D Honor Roll are Blue Cross Blue Shield …

U.S. News & World Report Announces The 2018 Best Medicare Plans - TheStreet | 10/16/2017

Essence Healthcare, Health Alliance Medicare, Health Partners, Kaiser Permanente, Martin’s Point Generations Advantage, Medica Insurance Company, MVP HEALTH CARE, Paramount Elite, Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This year, 15 of the 17 plans on the Medicare Part D Honor Roll are Blue Cross Blue Shield …

Coventry Health Care

U.S. News & World Report Announces the 2018 Best Medicare Plans | PR Newswire | 10/16/2017

Coventry Health Care, Essence Healthcare, Health Alliance Medicare, Health Partners, Kaiser Permanente, Martin’s Point Generations Advantage, Medica Insurance Company, MVP HEALTH CARE, Paramount Elite, Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This year, 15 of the 17 plans on the Medicare Part D Honor Roll are Blue …

U.S. News & World Report Announces The 2018 Best Medicare Plans - TheStreet | 10/16/2017

Coventry Health Care, Essence Healthcare, Health Alliance Medicare, Health Partners, Kaiser Permanente, Martin’s Point Generations Advantage, Medica Insurance Company, MVP HEALTH CARE, Paramount Elite, Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This year, 15 of the 17 plans on the Medicare Part D Honor Roll are Blue …

UnitedHealthcare

How UPMC-Highmark deal could rewrite the regions’ insurance playbook | The Business Journals | 6/25/2019

UPMC Health Plan, at the same time, has increased 10.6 percent. And there have been double-digit gains for national insurers Aetna, Cigna and UnitedHealthcare. Moody’s Investors Service said the 10-year contract between UPMC and Highmark is a “credit positive” for Highmark — and could help it regain membership lost during the years-long conflict with UPMC. “We view it as a positive for enrollment,” said Stefan Kahandaliyanage , a Moody’s …

Customer Contact Week Announces 2019 CCW Excellence Awards Finalists | PR Newswire | 5/8/2019

UnitedHealthcare Valvoline WebMD Health Services Best in Class Contact Center (200+ seats) Agilent Technologies Allstate Insurance Company Backcountry.com Best Western Hotels and Resorts Electronic Arts Kromtech Mailchimp TIAA UPMC Whirlpool Corporation Best Training & Development Program Agilent Technologies First American Title – SMS Division Florida Blue Gant Travel Grubhub Microsoft Samsung Electronics America TIAA UPMC UPMC Health Plan Vendor Categories Disruptive Technology of the Year Cogito Corp. Etech Insights Gridspace Language I …

MVP Health Care

U.S. News & World Report Announces the 2018 Best Medicare Plans | PR Newswire | 10/16/2017

… MVP HEALTH CARE, Paramount Elite, Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This year, 15 of the 17 plans on the Medicare Part D Honor Roll are Blue Cross Blue Shield plans. U.S. News used plan-ratings data from the Centers for Medicare & Medicaid Services (CMS) to …

U.S. News & World Report Announces The 2018 Best Medicare Plans - TheStreet | 10/16/2017

… MVP HEALTH CARE, Paramount Elite, Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This year, 15 of the 17 plans on the Medicare Part D Honor Roll are Blue Cross Blue Shield plans. U.S. News used plan-ratings data from the Centers for Medicare & Medicaid Services (CMS) to …

Anthem Blue Cross

U.S. News & World Report Announces the 2018 Best Medicare Plans | PR Newswire | 10/16/2017

Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield, Coventry Health Care, Essence Healthcare, Health Alliance Medicare, Health Partners, Kaiser Permanente, Martin’s Point Generations Advantage, Medica Insurance Company, MVP HEALTH CARE, Paramount Elite, Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This year, 15 of the …

U.S. News & World Report Announces The 2018 Best Medicare Plans - TheStreet | 10/16/2017

Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield, Coventry Health Care, Essence Healthcare, Health Alliance Medicare, Health Partners, Kaiser Permanente, Martin’s Point Generations Advantage, Medica Insurance Company, MVP HEALTH CARE, Paramount Elite, Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This year, 15 of the …

Donald Trump

Obamacare premiums were stabilizing. Then Trump happened. | MSN | 10/18/2017

… Obamacare premiums were stabilizing. Then Trump happened. Vox.com 1 hr ago Dylan Scott © Provided by Vox.com Back in May, the UPMC Health Plan in Pennsylvania said it would need to increase its health insurance premiums … been overhauled. The customers were still the same. But President Donald Trump had inherited an individual health insurance market that was starting to stabilize and decided to break it. After months of threats, Trump announced …

Ben Harder

U.S. News & World Report Announces the 2018 Best Medicare Plans | PR Newswire | 10/16/2017

… face an overwhelming number of options when deciding on the right health insurance plan that fits their specific needs,” said Ben Harder , chief of health analysis for U.S. News. “Best Medicare Plans was designed to … HEALTH CARE, Paramount Elite, Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This …

U.S. News & World Report Announces The 2018 Best Medicare Plans - TheStreet | 10/16/2017

… face an overwhelming number of options when deciding on the right health insurance plan that fits their specific needs,” said Ben Harder , chief of health analysis for U.S. News. “Best Medicare Plans was designed to … HEALTH CARE, Paramount Elite, Providence Health Assurance, Senior Preferred, and UPMC Health Plan. For Part D plans, which cover prescription drugs, 17 states have at least one insurer that made the U.S. News list. This …

Jeffrey Romoff

Here’s where Romoff says UPMC could expand next | The Business Journals | 11/3/2017

UPMC CEO Jeffrey Romoff at Friday afternoon’s news conference. Paul J. Gough – Reporter, Pittsburgh Business Times Nov 3, 2017, 5:09pm EDT UPMC CEO Jeffrey Romoff said Friday that the Pittsburgh-based health care giant will … UPMC fully statewide in terms of care providers and hospitals. UPMC Health Plan is already serving members in eastern Pennsylvania through a joint venture with Reading Health System . UPMC’s latest quarterly results, for the three

Here’s why UPMC saw big boost in net income | The Business Journals | 11/2/2017

… Total operating revenue in the quarter was $3.9 billion, up from $3.4 billion in the same period a year ago. UPMC Health Plan grew 7 percent to more than 3.2 million members. “We continue to … of its future initiatives and efforts.” UPMC President and CEO Jeffrey Romoff , Chief Medical and Scientific Officer Dr. Steven Shapiro , and EVP Leslie C. Davis are scheduled to attend, as well as Gov. Tom Wolf …

Tom Wolf

Employers throughout Pittsburgh feel sense of relief as UPMC, Highmark reach deal | The Business Journals | 6/24/2019

… The announcement of a 10-year “global” agreement between UPMC and Highmark by Pennsylvania Attorney General Josh Shapiro and Gov. Tom Wolf was barely an hour old. But Brooks said that the overwhelming sentiment for … have in-network access to all UPMC doctors and hospitals. UPMC Health Plan, on the other hand, will get access to some but not all of the Highmark-owned Allegheny Health Network. The in-network …

Here’s why UPMC saw big boost in net income | The Business Journals | 11/2/2017

… Total operating revenue in the quarter was $3.9 billion, up from $3.4 billion in the same period a year ago. UPMC Health Plan grew 7 percent to more than 3.2 million members. “We continue to … C. Davis are scheduled to attend, as well as Gov. Tom Wolf , Allegheny County Executive Rich Fitzgerald and Pittsburgh Mayor Bill Peduto . Ranked by Commercial enrollees local region 2016 Rank Business name (prior year rank …