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Most UPMC Hospitals and Other Facilities in Western Pennsylvania Will Be Out-Of-Network for Patients with Highmark Commercial Insurance After June 30, 2019
Most UPMC hospitals and other facilities in western Pennsylvania will be out-of-network for patients with Highmark commercial insurance after June 30, 2019. Below are answers to frequently asked questions about how your health care will be impacted. Q: Will UPMC Hamot be out-of-network after June 30, 2019? A: Yes, UPMC Hamot will be out-of-network for Highmark commercial members after June 30, 2019. Q: Will UPMC doctors be out-of-network after June 30, 2019? A: Yes, most UPMC doctors in Erie will be out-of-network for Highmark commercial members after June 30, 2019. Additionally, if you would like to see a UPMC doctor at, or near, another UPMC hospital or facility that will be out-of-network after June 30, 2019, you can expect that doctor to be out-of-network for you as well. Q: Will any UPMC specialty services be in-network for Highmark commercial members in western Pa. after June 30, 2019? A: Yes, in addition to Children’s Hospital of Pittsburgh of UPMC and Western Psychiatric Institute and Clinic of UPMC, a very limited number of UPMC specialty services will be in-network for Highmark commercial members in western Pennsylvania after June 30, 2019. Q: Will I have access to UPMC Hillman Cancer Center after June 30, 2019? A: No, Highmark commercial members will not have in-network access to UPMC Hillman Cancer Center services at UPMC Hamot, including clinical trials, after June 30, 2019. Q: How do I know if I have commercial insurance? A: Commercial health insurance policies often are provided as part of a group plan, such as through an employer or union. -
UPMC Year End Financial and Operating Report & Audited
UPMC Year End Financial and Operating Report & Audited Consolidated Financial Statements FOR THE PERIOD ENDED DECEMBER 31, 2020 UPMC YEAR END FINANCIAL AND OPERATING REPORT • DECEMBER 2020 | UPMC Year End Financial and Operating Report & Audited Consolidated Financial Statements FOR THE PERIOD ENDED DECEMBER 31, 2020 TABLE OF CONTENTS Introduction to Management’s Discussion and Analysis ............................... 1 Management’s Discussion and Analysis ........................................ 2 Consolidated Financial Highlights .......................................... 3 Business Highlights .................................................. 4 Condensed Consolidating Statements of Operations ............................... 6 Divisional Information ................................................... 7 Revenue and Operating Metrics ............................................. 9 Key Financial Indicators ................................................. 12 Market Share ....................................................... 13 Asset and Liability Management ............................................ 14 Utilization Statistics ................................................... 16 Outstanding Debt .................................................... 17 Debt Covenant Calculations .............................................. 18 Audited Consolidated Financial Statements ..................................... 19 Report of Independent Registered Public Accounting Firm ........................... 20 Consolidated Balance Sheets .......................................... -
Tobacco Settlement Report: FY 2017-18
THE TOBACCO SETTLEMENT ANNUAL REPORT TO THE GENERAL ASSEMBLY JULY 1, 2017 – JUNE 30, 2018 Tom Wolf Teresa D. Miller Governor Secretary of Human Services THE TOBACCO SETTLEMENT ANNUAL REPORT TO THE GENERAL ASSEMBLY JULY 1, 2017 – June 30, 2018 Page Executive Summary 3 Uncompensated Care for Hospitals (2017-2018) 4 Attachment 1 – Hospitals eligible for tobacco payment 7 Attachment 2 – Hospitals qualified to receive UC payments 12 Attachment 3 – Hospitals qualified to receive EE payments 16 Attachment 4 – Hospitals affiliations for tobacco payments 19 Attachment 5 – Hospitals with potential DSH-UPL issues 24 Attachment 6 – Total expenditures for each fiscal year 25 Attachment 7 – Uncompensated care (UC) payment method 28 Home and Community-Based Services to Older Pennsylvanians 30 Chart 1 - Aging Waiver Allocation Direct Service Costs 31 Table 1 - Summary of the Aging Waiver 32 Table 2 - Number of Applicants 33 Table 3 - Funded Individuals (Aging Waiver Program) 35 Table 4 - Total Expenditure by PSA 37 Table 5 - Aging Waiver Costs, Number of Claims and Consumers by Service Category for Fiscal Year 2017-2018 39 Table 6 - Costs, Number of Claims and Number of Unduplicated Consumers by Service Category for FY 2017-2018 40 Table 7 - Average State and Federal Costs per Individual 40 Medical Assistance for Workers with Disabilities (MAWD) 41 2 EXECUTIVE SUMMARY The Commonwealth of Pennsylvania joined 45 other states in November 1998 in a master settlement agreement (MSA) with the tobacco industry, estimated to total $206 billion over the first 25 years. Pennsylvania’s share was estimated to be about $11 billion between the years 2000 and 2025. -
UPMC Quarterly Disclosure
UPMC Quarterly Disclosure For the Period Ended June 30, 2016 UPMC QUARTERLY DISCLOSURE FOR THE PERIOD ENDED JUNE 30, 2016 TABLE OF CONTENTS Introduction to Management’s Discussion and Analysis . .1 Management’s Discussion and Analysis Financial Highlights . .2 Operating Component Information . .5 Revenue and Operating Metrics . .8 Key Financial Indicators . .11 Market Share . 12 Asset and Liability Management . 13 Utilization Statistics . 15 Outstanding Debt . 16 Debt Covenant Calculations . 17 Audited Consolidated Financial Statements Report of Independent Registered Public Accounting Firm 19 Consolidated Balance Sheets . .20 Consolidated Statements of Operations and Changes in Net Assets . .21 Consolidated Statements of Cash Flows . .22 Notes to Consolidated Financial Statements . .23 The following financial data is derived from both the June 30, 2016 audited consolidated financial statements of UPMC and the unaudited interim consolidated financial statements of UPMC The interim financial data includes all adjustments consisting of a normal recurring nature that UPMC considers necessary for a fair presentation of its financial position and the results of operations for these periods Operating and financial results reported herein are not necessarily indicative of the results that may be expected for any future periods The information contained herein is being filed by UPMC for the purpose of complying with its obligations under Continuing Disclosure Agreements entered into in connection with the issuance of the series of bonds listed -
Pennsylvania Health Professionals Call for an Investigation Into the PA Department of Health's Response to Fracking Complaints
Pennsylvania Health Professionals Call for an Investigation into the PA Department of Health's Response to Fracking Complaints Dear Elected Officials, As Pennsylvania nurses, doctors and other health professionals we are very concerned about the recent allegations that the Pennsylvania Department of Health (DoH) is obstructing attempts to investigate and remedy potential impacts from shale gas drilling in the Commonwealth. The Department of Health created a unique list of “buzzwords such as fracking, Marcellus Shale, and drilling, to guide any complaint from the public. Department of Health staff were specifically instructed not to respond to people who contacted them regarding health concerns related to the state’s unconventional natural gas extraction (or fracking). Instead, Department of Health employees were to refer these complaints to the Department’s Bureau of Epidemiology—different from any other health claim. This practice could have limited the Department’s professional staff from accurately monitoring and responding to health problems related to our state’s unconventional gas industry. We are calling for a full investigation of the Department of Health’s response to fracking complaints, immediately open up past and future health complaints to the public, and ensure all future complaints are fully addressed. Signed, 1. Perry Adelson, DDS, Private practice, Williamsport PA 2. David Albright, MD, Carlisle Regional Medical Center, Carlisle PA 3. Michele Amateau, CA&A, Penn State University, Boalsburg PA 4. Frances Amorim, RN, MSN, & CCE, Havertown PA 5. Jerry Anderson, Vice President, International Marketing, Medical device industry ,Centerville PA 6. Anastasia Antoniadis, MPH/CCC – SLP, Devon PA 7. Kaufman Arcene, RN, UPHS, Philadelphia PA 8. -
Designated Acute Care Hospital Stroke Centers 180424
Acute Stroke -ready; Comprehensive stroke COUNTY FACILITY NAME CITY ZIP Center or Primary Stroke Center? MONTGOMERY Abington Memorial Hospital Comprehensive stroke Center Abington 19001 ALLEGHENY Allegheny General Hospital Comprehensive Stroke Center Pittsburgh 15212 CUMBERLAND Carlisle Regional Medical Center Primary Stroke Center Carlisle 17015 FRANKLIN Chambersburg Hospital Primary Stroke Center Chambersburg 17201 CHESTER Chester County Hospital – Chester County Primary Stroke Center West Chester 19380 CAMBRIA Conemaugh Memorial Medical Center Primary Stroke Center Johnstown 15905 BLAIR Conemaugh Nason Medical Center Acute Stroke -ready Roaring Spring 16673 BUCKS Doylestown Hospital Primary Stroke Center Doylestown 18901 MONTGOMERY Einstein Medical Center Montgomery Primary Stroke Center East Norriton 19403 LANCASTER Ephrata Community Hospital Primary Stroke Center Ephrata 17522 WESTMORELAND Excela Health Frick Hospital Primary Stroke Center Westmoreland 15666 WESTMORELAND Excela Health Latrobe Hospital Primary Stroke Center Latrobe 15650 WESTMORELAND Excela Health Westmoreland Hospital Primary Stroke Center Greensburg 15601 LACKAWANNA Geisinger Community Medical Center – Scranton - Lackawanna County Primary Stroke Center Scranton 18510 MONTOUR Geisinger Medical Center – Montour County Primary Stroke Center Danville 17822 LUZERNE Geisinger Wyoming Valley Medical Center, Wilkes-Barre – Luzerne County Primary Stroke Center Wilkes Barre 18711 ADAMS Gettysburg Hospital Primary Stroke Center Gettysburg 17325 CARBON Gnadden Huetten Memorial -
Frequently Asked Insurance Questions
Frequently Asked Insurance Questions If I have a Highmark card, can I utilize UPMC Hamot Medical Center and their physicians? • Yes, but services will be processed under the out-of-network level of benefits, subject to a higher deductible, coinsurance and may be subject to balance billing. Emergency services will be covered at the in-network level of benefits. If I have a UPMC card, can I utilize Saint Vincent Health System and their physicians? • Yes, but services will be processed under the out-of-network level of benefit, subject to a higher deductible, coinsurance and may be subject to balance billing. What is Highmark’s provider and hospital network outside of Western Pennsylvania? • Highmark has a nationwide network and access to participating providers in each state. Will my prescription drugs remain covered if I switch from Highmark to another carrier? • Every carrier has a preferred formulary which is a list of drugs that offer the greatest overall value to the members. These formularies may vary slightly and are subject to change. What is Highmark’s preferred/formulary drug list? • You can access Highmark’s formulary by visiting their website at www.HighmarkBCBS.com Can I have UPMC coverage and my spouse have Highmark coverage? • Only if you are both employed at the Erie School District. Will there be a pre-existing condition disruption by moving to another carrier? • No, pre-existing conditions will not be affected. Can I switch back to my previous carrier if my employer offers a dual choice? • Yes, during your annual open enrollment period What UPMC facilities will remain in network for Highmark members after 7/1/2019? • Children’s Hospital of Pittsburgh (through 6/30/2022), UPMC Altoona, UPMC Bedford, UPMC Kane, UPMC Jameson, UPMC Northwest, UPMC Horizon (both campuses). -
The Relationship Between UPMC and Highmark Is Changing
The relationship between UPMC and Highmark is changing. After June 30, 2019, many UPMC hospitals and other facilities in western Pennsylvania will be out-of-network for patients with Highmark commercial insurance. Below are answers to frequently asked questions about how these changes may impact your health care. Q: Will UPMC Kane be out-of-network after June 30, 2019? A: No. UPMC Kane will remain in-network for most Highmark Network status of UPMC hospitals commercial members after June 30, 2019. in western Pennsylvania after June 30, 2019 Q: Do all Highmark plans provide full, in-network access Out-of- Hospital/Facility Name In-Network* to UPMC Kane? Network A: No. My Direct Blue, a plan offered on the Affordable Care Act’s insurance exchange, is considered out-of-network for all UPMC UPMC Altoona ü physicians and hospitals except UPMC Children’s Hospital of UPMC Bedford Pittsburgh and its physicians. ü UPMC Children’s Hospital ü Q: Will UPMC doctors be out-of-network after June 30, 2019? of Pittsburgh A: If you would like to see a doctor at or near a UPMC hospital or facility UPMC East û that will be in-network for you after June 30, 2019, such as UPMC UPMC Hamot Kane, you can expect that doctor to be in-network as well. û If you would like to see a doctor at or near a UPMC hospital or facility UPMC Horizon (both campuses) ü that will be out-of-network for you after June 30, 2019, such as UPMC UPMC Jameson Presbyterian, you can expect that doctor to be out-of-network as well. -
Residency Match List 2021
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE 2021 Residency List – Philadelphia Campus Anesthesiology (8) Family Medicine (con’t) Cook County Health and Hosp Sys, IL Jefferson Health - Northeast, PA (2) Hospital of the Univ of Pennsylvania, PA Lankenau Medical Center, PA Indiana University SOM, IN McLaren Health Care, MI Penn State Hershey Medical Center, PA Mike O'Callaghan Federal Hospital, Tower Health/Reading Hospital, PA (2) Nellis Air Force Base/Univ of Nevada UCLA Medical Center, CA School of Medicine, NV (2)* UPMC Pinnacle Hospitals, PA Naval Hospital Jacksonville, FL* NCC - Fort Belvoir Community Hosp, VA* Emergency Medicine (28) Northwestern McGaw Lake Forest, IL Albert Einstein Medical Center, PA (2) OhioHealth-Doctors Hospital, OH Capital Health Regional Medical Center, NJ OhioHealth-Grant Medical Center, OH Christiana Care, DE Penn Medicine-Lancaster General Hosp, PA CMSRU/Cooper University Hospital, NJ Penn State Hershey Medical Center, PA Crozer-Chester Medical Center, PA (3) Puyallup Tribal Health Authority, WA Florida Atlantic University Rowan University SOM, NJ (2) -Charles E. Schmidt COM, FL Rutgers-RWJUH Somerset, NJ Geisinger Health System, PA St. Lukes Hospital, PA Harbor-UCLA Medical Center, CA St. Lukes Hospital-Anderson, PA (2) HCA Healthcare/USF Morsani GME Suburban Community Hospital, PA -Oak Hill, FL Univ of Massachusetts Med School, MA Inspira Health Network, NJ (2) UPMC McKeesport, PA Jefferson Health - Northeast, PA (2) UPMC Presbyterian Shadyside, PA Jefferson Health NJ - Rowan SOM, NJ (2) UPMC Williamsport, -
Expiration Date Name of Approved Provider 1/9/2016 Accessmatters 5
Expiration Date Name of Approved Provider 1/9/2016 AccessMatters 5/19/2017 A & T Lectures LLC 11/6/2017 Abington Memorial Hospital 5/27/2015 ACTS Retirement-Life Communities, Inc. 6/15/2017 Adventist HomeHealth Network 4/19/2016 Aetna Northeast Region Patient Management Department 8/9/2016 Aria Health Hospitals 1/1/2018 ATECAM LLC 11/7/2016 Blue Mountain Health System 5/5/2017 Cancer Treatment Centers of America at Eastern Regional Medical Center 4/29/2017 Catholic Health System 11/7/2017 CHART Institute, LLC 11/7/2017 Conemaugh Health System 4/1/2016 Doylestown Hospital 1/8/2016 Drexel University College of Medicine/Division of Behavioral Healthcare Education 1/8/2016 Duquesne University School of Nursing 5/10/2018 Easton Hospital 6/26/2018 Evangelical Community Hosptial 5/18/2018 FF Thompson Hospital 7/1/2016 Fox Chase Cancer Center 8/1/2016 Geisinger Health System 11/18/2016 Geisinger-Lewistown Hospital 12/31/2015 Gerber Consulting Services, Inc 4/24/2017 Good Shepherd Rehabilitation Network 6/15/2016 Grand View Hospital 8/2/2018 Hahnemann University Hospital 8/2/2018 Hanover Hospital 4/27/2018 Heritage Valley Health System 4/27/2018 Holy Redeemer Hospital 2/14/2017 Holy Spirit Health System 8/26/2018 Home Nursing Agency and Visiting Nurse Association 4/29/2016 Hospice Chautauqua County, Inc 6/25/2018 Hospice of Lancaster County - Education Department 9/12/2016 J&K Seminars, LLC 9/13/2018 Jacobi Medical Center Nursing Education Department 9/12/2016 Jeanes Hospital 9/3/2015 Kaleida Health 6/30/2016 Kings County Hospital Center 8/9/2016 -
Acute-Care-Hospitals-Alphabetic.Pdf
Acute Care Hospitals Facility Name Facility # Facility Name Facility # Abington Health Center - Warminster 1410-09 Barnabas Health Jersey City Medical Center 2312-70 Campus(Warminster Hospital) Barnes-Kasson Hospital 1241-58 Abington Health-Lansdale Hospital 1432-46 Barnesville Hospital - Barnesville 1012-72 Abington Memorial Hospital 1001-46 Bath VA Medical Center 1062-71 Acuity Specialty Hospital of New Jersey (LTAC) 2310-70 (within Atlanticare Reg. Med.Ctr. Atlantic City Bayhealth Hospital, Sussex Campus 1012-68 Campu Bayshore Community Hospital 1039-70 AHN Harmar Neighborhood Hospital 1465-02 Beebe Medical Center - Lewes, DE 1003-68 AHN Hempfield Neighborhood Hospital 1130-65 Bellevue Hospital Center- New York, NY 1012-71 AHN McCandless Neighborhood Hospital 1464-02 Belmont Community Hospital (The Bellaire City 1002-72 AHN Neighborhood Hospital - Brentwood 1463-02 Hospital) Akron General Medical Center 1033-72 Belmont Hospital Bel Air 1026-72 Albany Medical Center Hospital - Albany, NY 1043-71 Benedictine Hospital 1001-71 Aliquippa Community Hospital (UPMC Beaver 1002-04 Berwick Hospital Center 1013-19 Valley Hospital) Beth Israel Hospital - Newark 1035-70 Allegheny General Hospital 1184-02 Beth Israel Med Ctr-Petrie Division (Manhattan) 1057-71 Allegheny Valley Hospital (Alle-Kiski Medical 1124-02 Center) Bloomsburg Hospital 1016-19 Anne Arundel Medical Center 1035-69 Bluefield Regional Medical Center 1029-73 Ardern Hill Hospital - Goshen 1017-71 Blythedale Children's Hospital 1063-71 Aria Health - Bucks County (formerly Delaware -
CY2020 Q4 Financial Results Media Slides
FINANCIAL RESULTS AND SYSTEM HIGHLIGHTS CALENDAR YEAR 2020 FEBRUARY 26, 2021 SUMMARY ▪ UPMC remains strongly positioned as the region’s most preferred provider and most preferred insurer best serving the needs of patients, members, businesses, and our communities during challenging times ▪ The largest medical insurer in western PA totaling 4 million members, with among the lowest-cost products in the nation ▪ Continuing substantial reinvestment in the region and beyond • $865 million in capital expenditures to enhance facilities and ensure continued quality of care 2 UPMC OVERVIEW ▪ Operating income of $836 million ▪ $9.9 billion cash and investments needed to run operations, fund provides for long-term sustainability capital expenditures and create new programs • UPMC Health Plan membership 11% • Value rises and falls based on market conditions • Outpatient revenue 3% • UPMC’s calendar year return 9.4% • Physician revenue 5% • Admissions and observations 10% 3• 3 UPMC OPERATING REVENUE Calendar Years Ended December 31 (Dollars in Millions) $23,093 $20,609 $18,777 $15,634 $13,462 2016 2017 2018 2019 2020 4 UPMC HEALTH INSURANCE PRODUCTS GROWING UPMC Insurance Services Membership CY 2020 vs. 2019: UPMC Largest Insurance By the Numbers: Market Share WPA* Membership CY 2020 vs. CY 2019 11%, 4 million members Employer Groups Offering UPMC Health Plan 7% Government Products (Medicare, Medicaid, CHC) 17% Workpartners National Client Membership 16% Revenue Growth (YOY): Grew top line revenue for CY 2020 to $12.3 billion, adding more than $1.79 billion YOY. ** *December 2020 5 ** Total Revenue *February 2021 What is Community HealthChoices? Community HealthChoices (CHC): Pennsylvania Department of Human Services program that contracts with managed care organizations to coordinate care for all adults who are dually eligible for Medicare and Medicaid services.