Highmark to Acquire West Penn Allegheny

The governing bodies of Pittsburgh-based health insurance provider Highmark and West Penn Allegheny Health System (WPAHS) have both given unanimous approval to a plan to allow the insurance provider to acquire the hospital system. The still unfinished deal calls for Highmark to pump as much as $475 million into the faltering health system.

The first infusion of cash will come in the form of a $50 million grant from Highmark to WPAHS. The WPAHS board approved an operating budget at the same meeting it approved the deal. “We had a backup budget that we would have passed had the Highmark transaction not gone forward and that budget would have included shutting down West Penn Hospital,” said WPAHS Board Chair David McClenahan. A portion of the grant will be used to shore up other aspects of the system in the short term.

WPAHS executives hoped to find a way to retain the independence of the system and ensure its financial viability but it became clear that was no longer possible. “Highmark was our only option,” said WPAHS CEO Christopher Olivia. Olivia will move over to Highmark as a consultant in the coming weeks. Highmark CEO Kenneth Melani said the viability of each hospital will be evaluated as the new organization moves forward.

West Penn Allegheny Health system has been struggling financially since it was formed out of the ashes of the failed Allegheny Health, Education and Research Foundation (AHERF) in 1999 and both the health system and Highmark have been in a feud with the University of Pittsburgh Medical Center and its insurance company in recent years. The Announcement of the Acquisition is just the latest step in that process.

“UPMC has attempted, for a little better than ten years, to put our health system out of business,” said McClenahan.

Melani said WPAHS will continue to offer to reach a deal with the UPMC Health Plan for its members to use its hospitals and doctors. UPMC Health Plan has not accepted that offer in the past.

Many Highmark customers have been worried about not having access to UPMC doctors and hospitals in the future and the deal has done nothing to quiet those fears. “As an insurer Highmark seeks to have contracts with all healthcare systems,” said Melani, “If for some reason UPMC continues to say they will not contract with Highmark… then we will have to deal with that through our products and services.”

The deal is pending regulatory approval at the state and federal levels.

UPMC Shares Data with State, Enjoys Federal Subsidies

UPMC has created a real-time electronic reporting system that provides information to Pennsylvania's immunization registry. They are doing this as part of the Centers for Medicare and Medicaid Services Meaningful Use Program.

According to the programs page, the program provides incentive payments to professionals, hospitals and critical access hospitals as they adopt or implement use of medical records technology to improve health care for those on Medicare or Medicaid. UPMC would be entitled to federal dollars for the amount of Medicare or Medicaid patients that receive care but this system will be applied to all of their patients.

Frank Caniglia, Chief of the Pennsylvania Statewide Immunization System says there are other systems similarly providing information to the state's system which has been in place since 2000. Eight million people of all ages are currently registered, usually as they receive vaccinations. UPMC is the largest of the systems currently providing electronic data to the state.

He called it a good thing for public health.

UPMC to Let Deal with Highmark Run Out

With Highmark recently announcing their plans to go from an insurance company to a provider by purchasing West Penn Allegheny Hospital System, this makes them a direct competitor with UPMC. Paul Wood, VP of Public Relations at UPMC said that when a contract the hospital system has had with Highmark to refer patients their way runs out in 2012 they will not renew.

He said this will not affect their clientele because of their strong relationships with other insurance systems.

Under the terms of the agreement, Highmark clients will have access to UPMC hospitals but will have to get approval and may face higher deductibles and co-payments.

UPMC Mercy and Children's Hospital have contracts that end in 2015 and 2022. Those contracts will be carried out.

Medical Teams Ready for Marathon

More than 18-thousand runners are expected to cross the start line in Sunday’s Pittsburgh Marathon but not all of them will finish.

“We expect to see one to three percent of runner visit our aid stations,” says UPMC Sports Medicine Medical Director Ron Roth. Roth will be overseeing more than 300 medical professionals who will be volunteering their time Sunday along the racecourse. Half of the treatments will be given at the 17 aid stations along the course and other half of the patients will be served in the massive medical tent to be set up this week on the North Shore.

Roth says most of the injuries will be simple blisters, bruises and strains but his team will be ready to take care of any emergency including heart attacks and low sodium levels. 25 ambulances are expected to be at the ready along with a mountain of supplies including 100 jars of petroleum jelly, 200 IV’s 4,600 alcohol wipes and 7,600 band-aids.

As Medical Director, Roth will be keeping his eye on the weather as well as the runners. Several weather stations will be set up along the course. “When we look at the weather we’re looking not only at the ambient temperature but we do some calculations,” says Roth, “That includes the humidity, amount of sun, the amount of wind. It’s called the Wet Bulb Globe Index.” The information will be conveyed to the runners through message boards and a system of colored flags.

Roth says the record number of runners means he will have a record number of customers.

Protest Highlights UPMC Tax Breaks

Save Our Community Hospitals, an organization that has been vocal about the closing and demolition of the University of Pittsburgh Medical Center Braddock, held a rally today to protest UPMC's non-profit status and the tax exemptions that go along with it. SOCH gathered outside UPMC's headquarters downtown. SOCH chairperson Tony Buba says UPMC's local contributions don't amount to much - "that $100 million, whatever they do for the Pittsburgh Promise, is peanuts compared to what they should be taxed." UMPC announced the closing in the fall of 2009. A judge approved the demolition of the facility in October 2010. More information on the closing of UPMC Braddock can be found here.

Highmark: No Deal to Acquire West Penn Allegheny At This Time

Pittsburgh-based health insurer Highmark, Inc. is trying to clarify reports by some local media about an effort to acquire the West Penn Allegheny Health System which would put the company into even greater competition with UPMC as both an insurer and a care provider.
Highmark issued a statement saying it is always interested in having discussions with key stakeholder and "looking for ways to improve the efficiency and quality of the region’s health care system. While the West Penn Allegheny Health System (WPAHS) is a vital element of the local health care system, Highmark does not have a deal to acquire WPAHS at this time."
The statement went on to say that for decades the company has encouraged competition among multiple health care delivery systems.
" Highmark has historically supported an inclusive hospital network that includes a broad mix of advanced care and community hospitals to meet the medical needs of its members."

Highmark's current contract with UPMC expires June 30, 2012.
" Contrary to some media reports, under the terms of the current agreement, Highmark members will continue to have access to UPMC hospital services through June 30, 2013. Highmark is continuing contract discussions with UPMC with the goal of finalizing an agreement, which will preserve provider choice and broad access to UPMC for Highmark members into the future."

Highmark has about 4.8 million insurance subscribers, three times that of UPMC.

UPMC Performs Less-invasive Aortic Valve Replacement

UPMC surgeons performed the first round of procedures that replaces patent's aortic heart valve without having to perform open heart surgery. The hospital is one of 40 hospitals nation-wide participating in the Medtronic CoreValve® Clinical Trial evaluating a non-surgical procedure as an alternate to open-heart surgery for aortic stenosis patients. The procedure requires doctors to channel a catheter through a small opening in the femoral artery to reach the patent's heart, then the CoreValve is guided to the aortic valve where it self-expands to replace the diseased valve.

William Anderson, director of Interventional Cardiology at UPMC, says that this procedure is different than other methods. "The gold standard of therapy for aortic valve replacement is to do it through open heart surgery, and that's an operation that we've done for a long time and we're very familiar with. The disadvantage to it is that it is maximally invasive and it has a relatively long recuperation period."

Anderson says that the procedure has yet to show whether or not t will be a commercial success. He says that there are two other valve replacements being made available commercially relatively soon and we should see in the next 12 months if either is successful.

Aortic stenosis prevents the heart's aortic valve from properly opening which leads to less healthy blood flow from the aorta to the rest of the body. Approximately 300,000 people suffer from aortic stenosis worldwide, one third being deemed too high risk for open heart surgery.

The CorevValve System will be available commercially until the end of its clinical trial and approval of the FDA.

UPMC Hopes for a Vaccine Factory

The University of Pittsburgh Medical Center hopes to put a vaccine factory that is partially federally funded in a 30 acre brownfield site in Hazelwood.

First, they would have to go through a selective process through the Department of Health and Human Services. If the facility were to be built in Pittsburgh, it would cost about $600 to $800 million dollars, with about half of that cost coming from UPMC and the other half coming from the government.

Last year the Department of Health and Human Services, which has set aside more than $12 billion to improve vaccine production asked for comments prior to requesting the Request for Proposal. UPMC submitted as did other institutions.

UPMC has established a non-profit arm to prepare for the facility called 21CB. It has partnerships with IBM, Merck and Co. and GE Healthcare.

If selected, Robert Cindrich, Special Advisor to UPMC's President Jeffrey Romoff, said it would be several years before the facility would be up and running. It would focus on flu vaccines and medical countermeasures for bio-terrorism. It's estimated the facility would employ thousands.

There are no other vaccine factories in Pittsburgh.

"That's one of the reasons why we're so interested in this. This is a new industry for Pittsburgh, it fits our high tech and health care face that we're putting on the region and we have the talent for it and this would be, we hope, the precursor for other businesses in the vaccine field," said Cindrich.

Razing of Braddock Hospital Okayed

Allegheny County Judge Lawrence O'Toole has signed off on the demolition of UPMC Braddock Hospital and the transfer of the property to the county Redevelopment Authority. Seven Braddock residents filed a lawsuit to stop the razing of the closed hospital, claiming UPMC violated their civil rights and the health system failed to adhere to laws that govern nonprofits.
Judge O'Toole ruled that the plaintiffs did not have legal standing to challenge the demolition. A UPMC spokesman says the razing of the main hospital building could begin Monday.
The state is providing $3 million for a new facility that will house a health services clinic, a community college center, a restaurant, and additional housing.

Searching for A Cure

As the population ages and is increasingly at risk for developing Alzheimer’s Disease, researchers continue searching for a cause and a cure.

Curcumin, commonly known as the spice Turmeric has been shown to have beneficial effects in patients with Alzheimer’s disease. The catch? A person would have to consume pounds and pounds of it a day or take 400 tablets of a supplement daily.
But with the help of a new foundation’s money researchers at The University of Pittsburgh and Harvard University are working together to create new drugs that will slow or cure the disease. And their focus is on the spice.

"Ninety nine point nine nine nine percent gets broken down – its thrown out by the body. So what they’re trying to do is find that 000.1 percent of curcumin that would get to the brain from pounds gets to the brain from taking one little pill. So that’s the whole idea here to make a curcumin derivative that’s stabile in the body but still does the same thing that curcumin does," said Bill Klunk, a professor of psychiatry and neurology at the University of Pittsburgh and Co-Director of the Alzheimer Disease Research Center.

This week they received $400,000 from The Cure Alzheimer’s Fund, a local foundation.
Alzheimer’s Disease is an irreversible, progressive brain disorder that destroys memory and thinking skills. Five million Americans have it. By 2050, 16 million Americans are expected to have the disease.

New Study About Mothers With Post-Partum Depression

A new study finds that certain parts of the brain in women with post-partum depression react less to images of scared or angry faces.

The study was conducted by researchers at The University of Pittsburgh. It’s in this month’s issue of The American Journal of Psychiatry.

A group of depressed and non-depressed post-partum mothers had their brains scanned while they viewed pictures of fearful and threatening faces. The depressed mothers were deficient in responding to the faces. Reseachers say this means that those mothers were not as aware of feelings and intentions in others, particularly their babies.

Researchers also found a reduction in brain activity associated with the maternal attachment process.

Their hope is to greater understand the causes of post-partum depression. Dr. Eydie Moses- Kelko at Pitt is the lead author on the study.

"It's possible that ppd is a subtype of depression that has a different brain mechanism and we sought out to try to understand this but we certainly need to study this in greater depth to know for sure whether there are differences," she said.

Fifteen percent of new mothers experience post-partum depression.

Braddock Mayor Agrees with UPMC

An agreement that settles a civil rights complaint against UPMC brought by Braddock Borough is hailed by Council President Jesse Brown in the Post-Gazette as a major victory, but UPMC told the paper it had already agreed to the provisions months ago.

Braddock Mayor John Fetterman says the seven-month delay achieved only "an ombudsman and a couple of health screenings". According to him, the lawsuit represents grandstanding and posturing by both Council and the Office of Civil Rights in the Department of Health and Human Services, which did not want to be perceived as impotent. He says if HHS really had any teeth, it would have kept UPMC from closing the hospital in Braddock.

Fetterman credits Allegheny County, and specifically Dan Onorato, for holding UPMC accountable and getting a commitment from UPMC and $3 million of state funding for a new facility that will house a health services clinic, a community college center, a restaurant, and additional housing. He says Council missed deadlines as it refused to approve the project because of its lawsuit, so that Braddock came dangerously close to losing something that may give the community a chance to bounce back.

UPMC to Expand by 500

Most of the 500 positions UPMC plans to add in the coming year will be at UPMC Presbyterian, UPMC Shadyside, and in the insurance division. The move comes as the non-profit announced operating income that jumped 13 percent in the fiscal year ending June 30. The jobs come just a few years after the now 20-hospital network cut a similar number of workers. UPMC Spokesperson Paul Wood says those positions were very different than the ones that will be created. Woods says the system always has about 1,000 job openings as it deals with attrition however he says he does not think they will have any problem filling the new positions. In its latest financial report UPMC reports it generated $8 billion in revenue and netted $240 million in operating income for fiscal 2010. That compares to $212 million in 2009.

UPMC Transplant Program Resolves Paperwork Violations

Hospital officials say state inspectors have revisited UPMC's Presbyterian Shadyside transplant programs and have determined that violations of federal documentation rules have been corrected. UPMC spokeswoman Kristin Beaver says on June 14 the Pennsylvania Department of Health "re-surveyed UPMC's transplant programs and they informed our staff that seven of our programs have been re-certified by the Centers for Medicare and Medicaid Services for the next three years."
A March inspection discovered "serious" violations and at the time UPMC said the paperwork problems were easily remedied. Inspectors never suggested that there was any danger to patients. However, if the health system had no corrected the problems within 6 months, it could have been denied Medicare reimbursements for transplants. Beaver says they expect to receive official notification of re-certification within a few weeks.

House of Hope

When UPMC shuttered Braddock Hospital earlier this year, they left few of their programs operating in the borough. Among them is House of Hope. It provides shelter and supports homeless, drug-addicted pregnant women and new mothers through the early stages of recovery. UPMC might be moving the program out of Braddock- which would deal another blow to an already distressed community. This story is part of our continuing coverage of behavioral health issues. Listen to it here.

Department of Defense Partners with McGowan Institute of Regenerative Medicine

The organizations are partnering to support treatments for battlefield injuries.

The two-year, $12 million dollar contract will push forward human trials for three research programs that will place healthy tissue in place of damaged tissue.
One program will replace muscle tissue with one’s own stem cells and to evaluate the injection of human connective tissue cells into contracted burn scars to allow greater freedom of movement.

Dr. Bernard J. Costello is Chief of Craniofacial and Cleft Surgery at the University of Pittsburgh’s School of Dental Medicine. He will be examining the effectiveness of a material to facilitate new bone formation in cranio-facial defects using a calcium phosphate cement. He showed an audience at Soldiers and Sailors Memorial Hall how it would work on Tuesday.

Costello says it’s an upgrade of technology that’s already FDA approved. It will be custom-tailored regenerative material that will turn into the patients own tissue.
"We can then get away from bone and soft tissue substitutes but really turn into designer materials that are regenerative, not replacement so we can get away from the carpentry of surgery and really get into the next stage of designing specific tissues that are for those types of problems," he said.

Eighty patients will be seen during the trials. 40 will be in Pittsburgh, the remaining at other locations. At least half of them will be soldiers.

Healthcare Ethics Forum at UPMC Mercy

Healthcare experts from UPMC, Duquesne University and the University of Pittsburgh gathered at UPMC Mercy Hospital to discuss healthcare ethics today.

Director of Pitt’s Consortium Ethics Program Rosa Lynn Pinkus says ethical issues are never labeled. She says it is the mission of preventive ethics to find and fix them before they become a crisis.

Pinkus says although most hospitals have ethics committees, they are often reactive, under-funded, or ignored. She says administrators must take a more comprehensively ethical approach to running their hospitals.

“What’s being talked about now is educating managers in charge of budget on how to look at ways one can justly and fairly allocate scarce resources,” says Pinkus. “Instead of just balancing a budget, having a process.”

Pinkus says because each case is different, medical workers should think critically in the case of each patient, and not have a “silo” approach in which they stuff people into the same category. She says while rules and laws are important, values are key.

Pinkus says the American Society for Bioethics & Humanities is adopting a more proactive and comprehensive approach to healthcare ethics.

Western Psych Will Use Federal Stimulus Funding to Study the Benefits of Counseling with HIV Screening

Western Psych is one of nine sites nationwide to receive funding from The National Institutes of Health to study if rapid HIV testing and counseling produce healthier results for those who test negative for the virus than testing alone. Western Psych will use Allegheny County's Health Department's STD clinic as their study site.

The $12.3 million dollar grant was awarded through the American Recovery and Reinvestment Act. Western Psych applied for the grant along with medical institutions in Miami and San Francisco. The sites selected across the country will represent a good cross section of Americans says Dr. Antoine Douaihy, Medical Director of Addiction Medicine Services at Western Psych and the study's chief researcher in Pittsburgh.

Researchers will begin recruiting for the study in a couple of weeks and will have done all of the research within 2 years. Requirements to participate are that participants use the county's health department clinic, be at least 18 years old, be HIV Negative or not know their status and be able to stay in touch with researchers.

Douaihy says physicians have been pushing to make rapid HIV testing and counseling an HIV prevention strategy. The CDC has recommended that prevention counseling not be required as part of the HIV screening programs and medical settings. This has been a point of controversy.

He says this will have public health implications in terms of researchers determining what sort of counseling reduces risky behavior.

Onorato Says Braddock Hospital Site Won't Be Abandoned

Allegheny County Executive Dan Onorato said Tuesday that the site that until last month housed UPMC Braddock will not be abandoned. He announced a plan to demolish the building and replace it with a multi-use building that would have senior-citizen housing, primary-care doctor's offices and work-force development classes from Community College of Allegheny County.

Onorato said UPMC has agreed to tear down the existing building if they cannot find a buyer. Then, the county will put out a request for proposals from private developers willing to develop the vacant site. The development would be funded by public and private dollars.

The cost to retrofit the building would be about 25 million dollars, he said, the cost to rebuild would be about 24 million.

The building would also have a cafe or restaurant and an ATM, the only one in the community.

Onorato said UPMC has committed to make payments to Braddock of $90,000 a year for five years in lieu of taxes. UPMC has also implemented shuttle service for residents -- five times a day -- from Braddock to the nearest hospitals.

The closing of the hospital was not a popular one with the residents of the borough.

Braddock Hospital Closing to Proceed

“Unless one has been living in a cave for the past few months, he or she could not fail to recognize that the closing of Braddock Hospital is a serious, if not crushing blow to the mostly poor residents of Braddock” – that’s according to Allegheny County Common Pleas Judge Gene Strassburger. Nonetheless, he denied County Councilman Charles McCullough’s motion to stop UPMC from closing the facility Friday. Strassburger says the evidence presented by McCullough did not require the hospital to stay open. But McCullough says this isn’t the end, and urged UPMC to go into negotiations with Braddock residents. He says he’ll abide by the wishes of his constituents and will “fight this to hell” if that’s where they want to go. If he appeals, it will be on the grounds that the judge misconstrued the laws. He says UPMC has to keep the hospital open "on a revenue producing basis—and if they wanted to close it they should have amended or paid off the bonds" issued by Bank of New York Mellon and Allegheny County. Braddock Mayor John Fetterman says he’s glad they had their day in court, even if the decision didn’t go their way. Fetterman says he’s not sure what comes next, though if there is a way to keep the hospital open they’ll fight for it. UPMC lawyer Jack McGinley says he feels that they’re on solid legal footing, but if McCullough wants to go for round two, he’ll see him in the ring. He says UPMC isn’t abandoning Braddock and is working with the community to mitigate the loss of the hospital.