Highmark downgrades UPMC Jameson tier status

Patients with Highmark Blue Cross/Blue Shield's Community Blue Flex plan will pay more for care services at UPMC Jameson than they did before the single hospital health system merged with Pittsburgh-based UPMC earlier this month, reports Ellwood City Ledger.

Last week Highmark told officials at New Castle, Pa.-based UPMC Jameson it was downgrading the hospital from Highmark's enhanced tier of coverage to its standard tier. Jameson Health System had been designated as enhanced prior to its merger with UPMC, which finalized May 1.

The status change will take effect Jan. 1, 2017, according to Highmark spokesperson Aaron Billger. Mr. Billger did not say whether the change was a direct response to UPMC's merger with Jameson, according to the article. None of UPMC's other facilities have contracted rate agreements with Highmark.

The status change will increase out-of-pocket costs for those who are insured through Highmark and receive care at UPMC Jameson. As a standard facility, Jameson patients' individual deductibles increase from $250 to $750, and families' deductibles increase from $500 to $1,500. Copayments increase from $25 to $50.

The change will affect fewer than 1,000, said Mr. Billger. 

More articles on payer issues: 

Wellmark to raise rates at least 38% for some Iowa customers
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6 things to know about non-embedded deductibles

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