Speculation growing regarding UPMC's newest move into Central Pa..........
- Thread starter ERICCARTMAN
- Start date
All these UPMC threads...what does this have to do with Pitt football?...am I missing something. No offense intended but shouldn't this be posted somewhere else.
HTP
HTP
If I'm UPMC, I'm posting a hospital within eyeshot of that dump Beaver Stadium and posting in giant bold letters University of Pittsburgh Medical Center. Remind the Pedos that Pitt is superior in medicine as well as any other aspect of the real world you chose. And I'd deny and scammed THON money too. UPMC doesn't need it.
Wouldn't it be funny if there were a UPMC Hospital in St College! PSU players being taken care of by PITT people.
You know what they used to say:
If you want to save farm animals, go to PSU
If you want to save people, go to PITT
You know what they used to say:
If you want to save farm animals, go to PSU
If you want to save people, go to PITT
More news outlets picking up the story now:
http://www.post-gazette.com/busines...t-for-hospital-expansion/stories/201703130020
http://www.bizjournals.com/pittsbur...-affiliate-with-harrisburg-region-health.html
The CHS-owned hospitals that might be in the mix actually are some of the more healthy ones.
Here's what the landscape in PA looks like currently for non-specialty hospital systems...
http://www.post-gazette.com/busines...t-for-hospital-expansion/stories/201703130020
http://www.bizjournals.com/pittsbur...-affiliate-with-harrisburg-region-health.html
The CHS-owned hospitals that might be in the mix actually are some of the more healthy ones.
Here's what the landscape in PA looks like currently for non-specialty hospital systems...
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It's official...they announced their intent to affiliate today:
http://www.post-gazette.com/busines...Pennsylvania-health-care/stories/201703140186
Might as well with all the speculation brewing.
http://www.post-gazette.com/busines...Pennsylvania-health-care/stories/201703140186
Might as well with all the speculation brewing.
Does UPMC and The University of Pittsburgh have anything in common besides the name? It's affiliated by name, like a branding partner, but seperate entity right? Or am I wrong? This has always confused me.
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I think they hire a lot of interns and residents. But, past that, I don't think they are officially affiliated. It would just be wonderful to see in State College.
Short answer yes: legally separate entity, but closely affiliated.
A slightly longer answer written by administrators at UPMC that actually published an academic article on the system: It is a mutually exclusive partnership of close affiliation formalized by a series of interrelated agreements and mutual executive oversights, which includes the sharing of numerous board members. This created a collaborative and coordinated decision-making model in which UPMC oversees all clinical activity, while the University of Pittsburgh remains the guardian of all academic priorities, particularly faculty-based research
Now, I'll fill out some more info starting with a shortened version of the history. The reality is, UPMC is technically and historically a Pitt spin-off company.
1920 Plan for the "University Medical Center"
The "University Medical Center" in Oakland was gathered and developed by Pitt over the course of 60 years starting back to 1910s, and slowly consolidated the hospitals together so by the 1980s they were merging into Pitt's Medical and Health Care Division. By the end of the 1980s, once Presbyterian University Hospital and Montifiore hospital merged, the name was changed to the "University of Pittsburgh Medical Center." Then to gain leverage against Highmark's insurance monopoly in the 90s, it formed the Tri-State Health System with hospitals outside Oakland...like St. Margaret's, Passavant, etc. They all soon merged together and they started their own health insurance subsidiary.
By the end of the 90s, UPMC was getting huge but it wasn't entirely financially sound, and it was in a fierce battle with ARHEF (which was actually larger at the time) and there were all sorts of scary changes coming down the pike with medicare reimbursements, etc. The massive bankruptcy of ARHEF was far from predictable at that point, but also illustrates the real danger some medical centers were facing (and still face).
What Pitt did was look at the logic of the head of medical center reporting to the Chancellor, and it effectively made no practical sense any more. The Vice Chancellor of the health science should not be running a giant medical system. But a big concern was the financial blow back from the risks UPMC was taking (and really all academic medical centers at the time) as it was growing and engaged in fighting fierce battles in its market sector, so there was a desire to create a financial firewall between the two entities in order to protect the university.
So the medical center was spun off, which took some serious untangling and exchange of various components, but the end result was two independent legal entities that are very closely affiliated and that includes shared governance and shared missions. Essentially, UPMC assumed control of all clinical practice aspects and all of Pitt's physician practices of the faculty in the med school. So all Pitt's medical faculty practice their clinical specialties in UPMC. Pitt retained all control over academic research, so all research grants are handled by the university and the faculty are professors and teach at Pitt. They get paid for their academic work by Pitt, and reimbursed for their clinical service by UPMC. (This isn't true of a doctor at UPMC Altoona, for instance, which is just an employee of UPMC.)
The governance is shared too. UPMC board of trustees is split 3 ways: 1/3 representatives from Pitt, 1/3 representatives from the Pittsburgh community at large, and 1/3 from their subsidiary hospitals. I believe UPMC's charter states that a mission is to benefit/support the university, and it does this in droves. UPMC pays a deans tax to the medical school, along with additional academic support, research support, etc. Essentially, these agreements with university run on 10-year contracts.
In FY15, UPMC's support to Pitt's med school was $190 million. That is an enormous number, more than the Commonwealth provides to the entire university, and absolutely more than any other medical school in the country gets in support from its affiliated medical center. If you wonder if there is an interest in UPMC doing well among Pitt supporters like me, this is the clearest and most tangible reason.
There are all sorts of intertwining collaborations between the two entities. If fact, things you may not realize, like the Carillo Street Steam Plant behind Trees Hall is a joint UPMC and Pitt project. Pitt and UPMC jointly operate the Medical and Health Sciences Foundation to fund raise for medical research and projects for both. There's the Pitt Cancer Center/UPMC Cancer Center collaboration. They're collaborating on starting a giant research institute in Italy. There are too many to list.
So yes, they are legally separate, but they are entangled like the snakes on a caduceus.
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Mount Nittany is the only hospital in Centre County and they don't have an interest in merging with anyone right now, and if they did, it would almost certainly be Penn State Health.
But really, UPMC Altoona is almost smack in the middle of ground zero, and UPMC is turning that into a major region hub, like they are doing to Hamot in Erie, Susquehana in Williamsport, and now Pinnacle in Harrisburg. So everyone in that area is going to be traveling to Altoona for their more serious issues, not to Hershey.
This isn't about football rivalry stuff at all, but if you want to sort of take that angle, there is nothing more troubling to Penn State than UPMC Pinnacle across the street. That is way more disconcerting to them than a UPMC Mount Nittany would be. Penn State-Hershey is the defacto top of the food chain in the Harrisburg region. Now they have a major competitor that they've never had before. They have Jeff, Penn, and Temple creeping up from the southeast and Geissinger from the northeast. They planned to grow into a system like all these others and got blocked from merging with Pinnacle and are stuck with a hospital in Reading that is bleeding money (-14% operating margin last year). It was the first, and still only, merger for their fledgling system. It will be interesting to see what they do, but they don't have great options. Honestly though, it wouldn't surprise me if UPMC collaborates with Hershey some down the road and may even supports them some. It has to hire PSU grads in the area and it is going to have to refer some case there because it has more advanced specialties, at least at the moment. Unless Highmark comes in and merges AHN with Penn State-Hershey, UPMC and Penn State-Hershey share a common enemy.
The most interesting part of this to me is the smaller hospitals involved in York, Lancaster, Carlisle, and Lititz. Pinnacle in Harrisburg doesn't have any immediate competition outside of Holy Cross and Hershey 20 miles away so UPMC gains the market share there. UPMC making in-roads in Lancaster and York counties creates direct competition for two regional giants who have grown large with pretty much no competition to speak of: Lancaster Health and Wellspan. Memorial has been a pretty irrelevant hospital in York for decades but I could see UPMC turning it into a real competitor for Wellspan in the growing I83 corridor. The Lititz hospital is also a direct competitor for Wellspan in Ephrata as well.
Edit: Looks like York Memorial is building a new hospital so perhaps they are already less irrelevant.
Edit: Looks like York Memorial is building a new hospital so perhaps they are already less irrelevant.
Carlisle, Lancaster, and Heart of Lancaster all have double digit operating margins. They seem fairly healthy. York has a negative margin, but only slightly negative over a 3 year average. But York is definitely the shakiest.
I think the CHS hospital acquisition reflect mostly Pinnacle's desire to grow because these hospitals will be part of Pinnacle's group of hospitals, just like Kane and Chautauqua are part of Hamot's sphere. I think the biggest thing for UPMC with the CHS hospitals is just being able to push their health plan into more counties. I don't think UPMC is so concerned with competing with WellSpan as much as leveraging a physical presence in these counties into a greater acceptance of the health plan. I think they'd figured out they can generate a lot revenue with insurance, and that they're pretty good at it since they have state-of-the-art analytics and access to some big data on the provider side that insurance companies probably don't. My guess is the health plan is driving these expansions out to these areas where they're not really going to be referring people to Presby anyway.
I'm also curious what will happen to JC Blair in Huntingdon. It is affiliated with Pinnacle but I don't know if that means integrated into the system.
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Interesting, thanks for the info. Seems like UPMC could walk into a Mount Nittany board room with a check and it would turn into UPMC State College pretty quickly...no?
A lot of Altoona doctors that UPMC "parted ways with" or really, wouldn't allow themselves to absorb into UPMC, are trying to set up shop in Tyrone, Roaring Spring, or at JC Blair in Huntingdon. Tyrone only has like twenty beds right now and Roaring Spring passes just about everything bigger than a broken arm to UPMC Altoona. That leaves Blair.
I'm going to guess that UPMC will want to make sure affiliate hospitals come under the umbrella for that reason, and that reason alone.
And, if the PSU thing is something that gets your juices going, there was a pileup on I-99 a week or so ago on the mountain above Happy Valley. UPMC Altoona went into a "code triage" and took all of the major cases.
Not really. Mount Nittany would have to want to become part of a system.
It isn't smart to expand just for expansion's sake. It has to be part of an overall strategy. UPMC didn't get to where they are by acting like ARHEF when it bought up any hospital that came on the market.
But almost every hospital has come around to the conclusion that they have to be part of a larger system in order to survive. The individual hospitals and smaller systems are actually approaching UPMC, typically not the other way around. And almost all of them, when soliciting bids and comparing options, want to go with UPMC and it isn't even close because of 1) the amount of local freedom UPMC lets them retain, 2) the amount of investment UPMC is willing to make into their facilities, and 3) UPMC is so far out ahead of everyone else on the electronic records and analytics and other cutting edge fields that allow it to optimize operation efficiency like few others. I mean, UPMC has spun off a few business that pretty much just consult to other health systems around the world based on UPMC's expertise in this area. So UPMC is actually selecting which hospitals in systems to merge with as much as those hospitals and systems are selecting UPMC.
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It already is the dominant provider based on size, and there will be no doubt after it merges with Pinnacle.
The thing to keep in mind is that UPMC got way out ahead of this trend in academic medical centers. It is the largest academic medical center in the country (I mean university affiliated, not something like Kaiser). Everyone else is now trying to copy their strategy. Luckily for Pitt, it was them and not some other system in PA like Penn or Temple or Jeff (or AHREF if they weren't incompetent).
UPMC Health Plan is essentially on equal footing with Highmark in Western PA. It will probably eventually be in Central PA. Probably not in Eastern PA.
However, I could see, for instance, perhaps UPMC taking over Geissinger's Health Plan. What I could see happening is smaller hospital systems in Easter PA turning to UPMC to manage and run their own branded health plans. So that, for instance, maybe Geissinger's or St. Luke's would offer a UPMC Health Plan which was branded as their own (for which UPMC would receive a cut after operating expenses). They'd be more closed system plans like UPMC Health Plan is.
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Any time there is change, people leave and that happened at Altoona. Here's the problem though, going by FY15 operating margin numbers: Nason -10.91%, Tyrone -4.95%, JC Blair -2.91%. They're all struggling small hospitals that in no way could survive on their own.
Nason was originally set to merge with Altoona, but when the UPMC merger with Altoona started to ramp up again, it got scuttled (as a now unnecessary drain on the Altoona system). Bedford was actually placed under Altoona's administrative control, and that is more of the time of community hospital you see being the tertiary level hub within UPMC's hub and spoke model. There are some small legacy hospitals in the UPMC system, like Kane Community Hospital in McKean County, which was affiliated with Hamot before Hamot merged with UPMC. Likely Kane would have never gotten into the UPMC system without first being run by Hamot, and that is the story that didn't play out well for Nason. Nason ended up merging into the Conemaugh system that was bought by for-profit Duke LifePoint. Other than the main hospital in Conemaugh, that group is really struggling.
Tyrone was set to be come of Penn State Health. That essentially got blown up when the PSU-Pinnacle merger got blocked. Don't know what Tyrone will do now.
JC Blair may just got their golden ticket. I don't know, though, if UPMC needs them to come into the fold. The physicians that left Altoona aren't really affecting it one bit. UPMC just backfills with, sometimes, even better credentialed physicians. It's like when Anastasi got pissed and left Altoona...he'd been there forever and was the star at Altoona for decades, but UPMC just brought someone even more qualified (at least on paper).
Conemaugh Hospital in Johnstown, is a piece of crap. Duke LifePoint is running the hospital into the ground.
I don't know the story about Lee Hospital, but if Lee would have stayed with UPMC. They would be the dominant
hospital in Johnstown.
Who is Windber Hospital affiliated with now?
I don't know the story about Lee Hospital, but if Lee would have stayed with UPMC. They would be the dominant
hospital in Johnstown.
Who is Windber Hospital affiliated with now?
Lee was acquired by UPMC around 1998 right after the time the community hospitals of Tri-State Health System were merging into UPMC so it was very early in the growth of the UPMC system. I don't know for sure, but my guess is they were adding hospitals just to get bigger in response to AHREF's expansion, which in 1998 had grown into the largest non-profit healthcare system in the US and was about to collapse. These early additions to UPMC were probably done without much thought to any long-term strategy and more in a response to its largest competitor. My guess is Lee was just poorly positioned in the Johnstown market; it was bleeding money, and the market probably just wasn't big enough for competing systems. So UPMC likely just decided it wasn't worth the investment to try to compete with Conemaugh and probably decided just to get out (by selling it to Conemaugh). That's just a guess. Western PA was very over bedded. That sort of thing played out with some of the weaker community hospitals that were part of Tri-State that originally merged into UPMC at the very beginning of its 1990s formation. Alliquippa Hospital was cut loose and eventually closed. Braddock was offered to anyone, fully equipped, for free, but was closed when there were no takers. Southside hospital was reduced to an outpatient center. UPMC is a lot more mature and strategic about who it merges with now, and obviously, it is a lot more financially sound than it was at the end of the 90s. All the hospitals that have merged into UPMC the last 12 years or so have only seen their services expanded and they've all been successful.
Windber was purchased by Los Angeles billionaire doctor Patrick Soon-Shiong. Windber had a little research institute which became part of his Chan Soon-Shiong Institute of Molecular Medicine. So, it is not really part of a larger system. It is sort of a weird transaction. It is almost like this guy just wanted a hospital and home for his own little research institute. Windber's had a negative operating margin for the last 3 years.
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You'd get pissed too if you built a program from the ground up and then got a lowball, "take it or leave it" offer on your contract renewal.
I'd also add that Anastasi doesn't "look good" on paper because he worked on people nobody else would touch. He was an "aggressive, liability" to UPMC.
Also, the guys that are leaving for Blair were shut out because they wouldn't sign on with UPMC. They're now offering similar services in the same market. Are using places like Blair because they can't get lab time at Altoona any more.
you really want to go there pedo nitter? Since the stuff that happened at your cess pool pretty much trumps anything since it was basically university sanctioned.
what I really wonder about is who replaces Romoff, he is over 70 now, hope he doesn't try and pull a Paterno and go on forever.
Absolutely I'm sure he was pissed. They were replacing him as head of the heart & vascular institute. They all but asked for his resignation.
The guy they brought in to replace him was somewhat more of an academic. He's on the faculty at Pitt Med, publishes a little, etc.
Interesting...http://www.pennlive.com/news/2017/03/hershey_med_ceo_urges_employee.html
"Hillemeier had said Hershey was open to a wide range of partnerships and arrangements with other health care providers in the region. But he said he doesn't expect Hershey to merge, acquire or be sold to another large system."
They don't have great options.
"Hillemeier had said Hershey was open to a wide range of partnerships and arrangements with other health care providers in the region. But he said he doesn't expect Hershey to merge, acquire or be sold to another large system."
They don't have great options.
Don't think that would ever happen for multiple reasons...a big one is the same reason Pinnacle was blocked from merging with Hershey.
UPMC Pinnacle will collaborate with Hershey on some things, I'm sure, as Pinnacle does now. Again, for UPMC, I think this is all about spreading their health insurance eastward.
In my non-expert opinion, No, not anytime in the near future that I can foresee. That is way too competitive of a market (Penn, Jeff, Temple, Einstein, Tenet) with way too many good "brands" and there aren't really any independent hospitals or systems there that would likely be interested or need UPMC. I couldn't see how the resources needed to get in there to the degree needed to open up Philly's insurance market would be justified, and I don't see why UPMC would want to be in a place where it wasn't a first choice type of brand.
The only real hypothetical possibilities that I could see that remain for possible mergers in the Philly market might be Einstein and/or Main Line, but I don't know why they'd be interested in UPMC.
I don't think there are many more places for UPMC to go in Pennsylvania after Harrisburg. Maybe the Northeast corner of the state but it isn't as if that is population rich. It's all smaller community hospitals up there and it is pretty much a Geisinger region and they have their own health plan that I don't think UPMC really cares about competing against. If the Pinnacle mergers all go through, UPMC is looking at 17-18% market share of the entire state, and favorably aligned with another couple % points of providers, and most those markets UPMC has the top facilities in their respective regions. The next closest system is Penn at 7-8%. I think that gives UPMC the position they want against Highmark.
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I was working in the south central PA area for a few years. PSU Hershey treated us terribly as referring docs. They would not communicate to us about transferred hospitalised patients and were bad with getting their referral notes out to us. Patients would come into the office after procedures and after consultations and we would have no information about what happened or what was planned. The patients would get mad at us for not knowing! Also, when we called to transfer a patient, PSU Hershey routed those calls to a resident, who would generally be rude and condescending to us. We starting referring and transferring to Harrisburg because we spoke directly to the specialist, and they would personally call us with frequent updates on our patients.
PSU Hershey specialists then wanted to visit our office and buy us lunch once we stopped sending them our patients. It was too late as the service with Harrisburg was superb. Some subspecialties out of PSU Hershey were great though, and we continued to refer to those.
PSU Hershey specialists then wanted to visit our office and buy us lunch once we stopped sending them our patients. It was too late as the service with Harrisburg was superb. Some subspecialties out of PSU Hershey were great though, and we continued to refer to those.
