Becker's Hospital Review

78 POPULATION HEALTH 78 CEO/STRATEGY UPMC CEO Jeffrey Romoff on ongoing feud with Highmark: 'That's what disruption is about' — 5 things to know By Leo Vartorella U PMC and Highmark Health, both based in Pittsburgh, have been locked in a yearslong feud fueled by the con- tinued hybridization of their organizations. eir respective CEOs look upon this dispute with more optimism than patients, according to e Washington Post. UPMC is an established provider that also owns an insurance services division cover- ing 3.2 million people in western Pennsyl- vania, while Highmark's insurance covers 5 million people across three states and is the fourth largest Blue Cross Blue Shield-affiliat- ed organization in the nation. Since 2011, the health insurer has expanded its provider ser- vices. Highmark reported an operating rev- enue of $18.6 billion in fiscal year 2016, the most recent figure available, while UPMC's operating revenue was $14.3 billion in fiscal year 2017. Here are five things to know about the per- spective Highmark and UPMC leaders bring to their feud, based on reporting from the Washington Post. 1. Many Pittsburgh-area residents believe the relationship between Highmark and UPMC is a contentious one, as evidenced by increas- ingly aggressive ad campaigns and contractu- al fights, that has pushed each organization further into individual silos. UPMC CEO Jeffrey Romoff differs in opinion. He said the competition — which took off in 2011 upon Highmark's foray into the provider realm — is an essential agent of innovation. "In the midst of it, [the competition] was disruptive. 'Oh, they were at each other's throats' — and that's the way it appeared, but that's what disruption is about. And let's be clear about this: Without disruption, change is much, much slower," said Mr. Romoff, ac- cording to e Washington Post. 2. While many of UPMC's goals are related to research innovations and highly complex proce- dures, Highmark CEO David Holmberg views his organization's mission as much simpler. "I want to keep people healthy; I want to keep them out of the hospital. ink of it like a consumer market," Mr. Holmberg said, ac- cording to e Washington Post. "You can do things differently because you're not worried about heads and beds. You're not trying to fill up the hospitals." 3. Mr. Romoff does not rest his sights solely on local competition, but instead looks be- yond the horizon as tech companies such as Amazon begin to enter the healthcare space. "ere's nothing in healthcare, that we know of, that UPMC doesn't have an entry into that marketplace," said Mr. Romoff, according to e Washington Post. 4. ough the top executives at Highmark and UPMC may see their feud in optimistic light, patients caught between these organiza- tions are not as hopeful. "I call it 'the war,'" said Sue Kerr, a Highmark member with a UPMC physician, according to e Washington Post.Treatment options for Ms. Kerr's tendinitis were complicated by her Highmark plan's inability to cover UPMC specialists. "You should consider switching providers, switching insurances — switch this, switch that. I was like, 'We paid for this.'" 5. e UPMC-Highmark relationship grew tense in 2011 aer Highmark rolled out plans to acquire the struggling Pittsburgh-based Al- legheny Health System for nearly $500 million. e move was part of the insurer's $1 billion transition to become a dual payer and provider. With Highmark acting as a competing provid- er, UPMC announced it would kick Highmark's health plan members out of its network aer their contract expired. ough intervention from state lawmakers led to a contract exten- sion, the new agreement only lasts until 2019. n Executive shakeout at Philadelphia hospital — CEO, CMO, CNO and 2 others to depart By Alia Paavola T he new owner of Philadelphia-based Hahnemann University Hospital is replacing several top managers at the hospital this spring, including the CEO, CMO and CNO, according to The Inquirer. Hahnemann University Hospital's CEO Michael Halter will depart April 13; its CMO George Amrom, MD, will retire June 30; the hospital's CNO Rosemary Dunn, RN, will leave April 1; the Chief Business Development Officer Robert Pavlich will depart March 31; and its interim Chief Human Resources Officer Richard Dodsworth will also be replaced. The new owner, American Academic Health System, which is a company formed by El Segundo, Calif.-based Paladin Healthcare, is currently searching for replacements. "Each of these individuals in their own way has made profound contributions to the well-being of Hahnemann University Hospital, as well as the Philadel- phia region. We appreciate and are indebted for their many years of service and their thoughtful leadership," American Academic Health System said in a statement, according to The Inquirer. The leadership shakeout comes just six weeks after the American Academ- ic Health System purchased Hahnemann University Hospital and Philadel- phia-based St. Christopher's Hospital for Children from Dallas-based Tenet Healthcare for $170 million. No management changes were made at St. Christopher's Hospital, according to the report. n

• Cover