Monroeville Mayor Greg Erosenko proudly refers to it as “mini Oakland,” the one-mile stretch of Mosside Boulevard housing rival hospitals owned by UPMC and Allegheny Health Network.
For Erosenko, business booms in a medical corridor with more jobs, more commerce and more competition between AHN’s community mainstay Forbes Hospital and the glistening, state-of-the-art UPMC East.
“Sincerely, it has been good not just for Monroeville residents, but for everyone out east,” the mayor said. “The competition has kept both health systems on the cutting edge, and that’s definitely not a bad thing.”
As UPMC postures to build a controversial hospital in the South Hills — less than a mile from AHN’s Jefferson Hospital — Erosenko points to the eastern suburbs as a model for coexistence of dueling hospitals.
An open question is whether 341-bed Jefferson Hospital can handle the competition. AHN lost $39 million in 2015, according to financial documents filed with the Pennsylvania Insurance Department.
David Holmberg, president and CEO of AHN’s parent company Highmark Health, is confident Jefferson will thrive. Still, he’s not thrilled with the prospect of a neighboring hospital in the South Hills.
“I don’t think we need more beds in the region,” Holmberg told the Tribune-Review. “Jefferson is an excellent facility. It has everything people need in the South Hills to take care of them. You have to ask what the motivations are for putting a hospital right next to a high-performing institution like that.”
UPMC plans to invest as much as $200 million to build the proposed 300,000 square-foot UPMC South, similar in size to UPMC East, with promises of 500 permanent jobs. The health care giant’s most recent plan was to build UPMC South in Pleasant Hills off Route 51 at Lindsay-Snyder Drive, although resident complaints could persuade UPMC to select an alternate site. A hearing on the plan before the Pleasant Hills zoning board is scheduled for April 25.
“We are optimistic that the UPMC proposal will foster sustained economic development in the 51 corridor,” said John Biedrzycki, vice president of the South Hills Chamber of Commerce. UPMC Health Plan is a member of the chamber. AHN is not.
Paul Wood, spokesman for UPMC, said motivation for building UPMC South is simple: thousands of UPMC Health Plan members live in communities along the Route 51 corridor that want and need a local hospital.
The South Hills proposal has opened a new chapter in an ongoing feud between UPMC and Highmark. As a result of the dispute, most UPMC hospitals no longer accept most Highmark insurance and UPMC Health Plan doesn’t contract with most Allegheny Health Network hospitals.
There are some exceptions. A Pennsylvania Supreme Court decision issued in late November required UPMC to include seniors in a group of “vulnerable” Highmark patients that the state is requiring UPMC to continue treating until 2019, when a consent decree governing relations between the nonprofits expires. People with Highmark insurance who are disabled, poor or engaged in a “continuing course of treatment” at UPMC hospitals are also protected until 2019.
Another exception is Jefferson Hospital. Unlike the other hospitals in Allegheny Health Network, Jefferson admits anyone with UPMC Health Plan insurance because it has a separate contract with the insurer. The terms of that contract, including when it expires, are confidential, both systems said.
“We do provide access to UPMC patients at Jefferson, whereas UPMC has said to us, they don’t want to see Highmark customers,” Holmberg said. “They have made it very clear. So it’s a different motivation.”
BOOST IN SERVICES
When UPMC announced plans for a hospital in Monroeville, said Forbes Chief Medical Officer Mark Rubino, patients asked: “Why are they hurting you? Why are they trying to kill you?”
“Most cities are not building additional hospital beds in a stable population. Yet, that was the UPMC model,” Rubino said. “Here, we try to provide high quality, comprehensive acute care services. We need to have strong core services to do that. To have it diluted by excess bed capacity doesn’t really make sense.”
Mark Sevco, president of UPMC East, said demand prompted the opening of the Monroeville hospital. UPMC Shadyside was over capacity and 30 percent of its patients were driving into Pittsburgh from the eastern suburbs, he said. The $250 million UPMC East opened in 2012.
“Our strategy was to provide low-cost, high-quality care in a community where our patients live,” Sevco said.
Forbes executives point out their hospital is full-service, offering medical services that UPMC East does not, such as open heart surgery, inpatient psychiatric care, complex brain and spine surgery, trauma care and baby deliveries. Forbes is certified as a Level II trauma center, which Holmberg said saved lives during the April 9, 2014, stabbings of 20 students and an adult at Franklin Regional High School in Murrysville.
UPMC East is just one piece of a regional Western Pennsylvania network that satisfies the full range of patient needs, Sevco said. Trauma patients can be flown by helicopter to UPMC Presbyterian or Montefiore hospitals in Oakland. Magee-Womens Hospital offers quality women’s health care, he said.
At UPMC East, planners sought to avoid duplicating services of other UPMC hospitals, Sevco said. Planners left the more complicated procedures to doctors who perform the procedures more often. Research shows that medical teams that perform higher volumes of procedures often have better outcomes, he said.
UPMC East does medical imaging and heart procedures, has a critical care unit, a rehabilitation program and performs a broad range of surgeries, he said.
“In medicine, like most things in life, the more you do something the better you are at it,” Sevco said. “For us, it’s about supporting a network of coordinated patient care, not duplicating services within our network. The focus is integrated and we work very hard at making patient transfers seamless.”
Forbes took a hit when UPMC East opened, losing 17 percent of its emergency department patient volume, according to its president and CEO Duke Rupert. However, much of the volume has bounced back, he said.
“We still have our challenges going forward with UPMC East right here,” Rupert said. “Obviously, if you put another inpatient facility in the community, it starts to split the volume.
“I think the future is bright for Forbes, but it’s not without investment and time and expenses.”
Since the formation of AHN in July 2013, Highmark has invested about $34 million in renovations, new technology and program expansions at Forbes.
Among them: a new trauma program, a new 20-bed intensive care unit, an expanded obstetrics and postpartum unit, installation of an electronic medical record system, a reconstructed emergency room waiting area, a dedicated patient elevator tower designed to improve the admission and transport of patients throughout the hospital and new signs atop and outside of the hospital.
The investments aren’t lost on Monroeville resident Kimberly Miller, 47, who wondered whether Forbes would survive after UPMC East opened.
“As a resident, I was very nervous that Forbes would immediately shut down and become a vacant eyesore in the community,” she said. “On top of that, there would be lost jobs. Nobody wants that.”
Miller, who three years ago switched from Highmark to a UPMC health insurance plan for her family, is thrilled with the convenience of UPMC East. A mother of four, she has made several visits to the emergency room for bumps, bruises and illnesses.
“The parking is great, there are low wait times and the building is super clean since it’s brand spanking new,” she said.
Although she hasn’t visited Forbes much since her switch in health insurance, she is pleased that Forbes is still around.
“They are certainly putting on the persona that they are making improvements and trying to stay a leader in health care out here,” she said.
Bernhard Erb, who served on Monroeville’s council from 2010 through 2014, said he believes UPMC’s plan is to continue growing locally, nationally and internationally. He joked that the only headache associated with UPMC East’s construction was creating an extra turning lane off Mosside into the hospital campus area.
“You’ve got great doctors at both facilities in Monroeville; you’ve got many of them moving to the region,” he said. “If the only benefit this new hospital brings to the South Hills is doctors and surgeons with six-figure salaries moving into the area, that’s still a great thing.”
Ben Schmitt and Wes Venteicher are Tribune-Review staff writers. Reach Schmitt at 412-320-7991 or firstname.lastname@example.org. Reach Venteicher at 412-380-5676 or email@example.com