Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Aetna's Inroads into the Market

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Aetna's Inroads into the Market

Article excerpt

A year ago, UPMC "wouldn't even give us an audience," recalled Mark Bertolini, chairman, CEO and president of insurance giant Aetna. It, like other non-Highmark insurers, had been virtually shut out of the Pittsburgh market for a decade, he said.

Mr. Bertolini was in town Wednesday for his first face-to-face meeting with UPMC President and CEO Jeffrey Romoff since the two signed an expanded contract last spring giving Aetna subscribers in- network access to all UPMC hospitals and physicians in Western Pennsylvania for the first time since 2001.

"Situations make strange bedfellows," said Mr. Bertolini, with a smile. "Generally we have the makings of a good relationship and this market will be better off as a result."

Aetna, headquartered in Hartford, Conn., just completed its first open-enrollment period under its new, expanded contract with UPMC, a deal similar to pacts the health system has signed with Cigna, United Healthcare and HealthAmerica.

With the current UPMC-Highmark contract ending in less than 18 months, Aetna already has snagged 22,000 employees at Education Management Corp. previously covered by Highmark.

But Mr. Bertolini said there's a long way to go.

"We've had a good start. It takes a little while for a market to believe you're committed, particularly the broker market."

What has opened up the Pittsburgh market is UPMC's announced intention not to renew its contract with Highmark when their pact ends in July 2013. UPMC has said that decision is based on Highmark's move to acquire competitor West Penn Allegheny Health System.

Mr. Bertolini said Mr. Romoff reiterated Wednesday his intent not to contract with Highmark unless the Pittsburgh insurer changes its position, or unless some regulatory agency compels him to renew.

Now, with 3 million covered lives in play, said Mr. Bertolini, Pittsburgh is "a great market. …

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