WILKES-BARRE — Commonwealth Health has signed a contract that provides in-network access to UPMC Health Plan members at its six hospitals in Northeastern Pennsylvania and affiliated provider networks.
“In network” refers to providers or facilities with which a health plan has negotiated a discount, and customers typically pay less when using those providers than with a facility outside the network.
The deal gives Pittsburgh-based UPMC Health, with its 3.4 million members, access to Commonwealth facilities as it rapidly expands across the state, while opening up a broad new client base for Commonwealth.
Asked whether the move was a prelude to a sale, Commonwealth Health spokeswoman Renita Fennick stressed that the contract relates only to insurance plan access.
“This new agreement solely relates to expanding access to care for individuals who have UPMC Health insurance plans. That has been our only focus throughout negotiations,” Fennick said.
“UPMC Health Plan is just one of many insurers we have contracted with to provide health care services for their members.”
Commonwealth Health continues to maintain its status as a preferred provider for Highmark Blue Cross Blue Shield plans and has contracts with major insurers in the area, officials said, including Aetna, Cigna, Geisinger Health Plan and UnitedHealthcare.
Pittsburgh-based UPMC is owned by UPMC, as the University of Pittsburgh Medical Center is generally known. Together, the medical system and health plan have grown well beyond western Pennsylvania to have a footprint across much of the state.
UPMC insurance products were available in 36 Pennsylvania counties in 2017, officials said, and through expansions are now available in 51 counties. Plan officials expect to have a presence in all 67 of the state’s counties by 2019, spokeswoman Gina Pferdehirt confirmed.
UPMC Health’s deal with Commonwealth Health covers Wilkes-Barre General Hospital, First Hospital in Kingston, Berwick Hospital Center, Moses Taylor Hospital and Regional Hospital of Scranton and Tyler Memorial Hospital in Tunkhannock.
It also includes access to the Commonwealth Health Physician Network, which employs primary care providers and specialists who are on the medical staff of the facilities; as well as the InterMountain Medical Group, Physicians Health Alliance, Berwick Medical Professionals and Great Valley Cardiology.
“This agreement provides a significant benefit for the people of Northeastern Pennsylvania who are covered under UPMC Health Plan and now have the ability to choose from a wide array of advanced health services and skilled physicians available at Commonwealth Health,” Cor Catena, CEO of Commonwealth Health, said.
Commonwealth Health’s hospitals are in Wyoming, Columbia, Luzerne and Lackawanna counties, and through Great Valley Cardiology it has offices in Wayne and Susquehanna counties, Fennick added.
“UPMC Health Plan is pleased to include Commonwealth Health in our network of hospitals to better service our members,” said Sandy McAnallen, senior vice president of clinical affairs and quality performance at UPMC Health Plan.
This is not the first interaction involving UPMC and properties owned or formerly owned by Tennessee-based Community Health Systems (CHS), Commonwealth Health’s parent.
In 2017, UPMC made a major push into the state’s capital region with the acquisition of Harrisburg-based PinnacleHealth.
That organization had very shortly before acquired four CHS-owned hospitals in Central Pennsylvania, in a move that was covered by $235 million UPMC borrowed from the Pennsylvania Economic Development Financing Authority.