Sasun Bughdaryan︳Unsplash
Sasun Bughdaryan︳Unsplash
UPMC Calendar Year 2022 Results:
- Operating results of $238 million; operating revenue of $26 billion.
- UPMC Insurance Services Division, the largest health insurer in western Pennsylvania, grew 9% to nearly 4.5 million members.
- UPMC continues to advance patient care with strategic capital expenditures totaling $994 million.
- $8.7 billion in cash and investments provide for long-term sustainability.
“During this difficult year in health care, our commitment to UPMC’s core mission did not wane. We substantially invested for the long-term, improving access to our clinical care and community servicesthroughout all our regions with emphasis on meeting strong patient preference for care to be provided more conveniently in ambulatory settings closer to home,” said Edward Karlovich, executive vicepresident and chief financial officer of UPMC. “Patient volumes continued to shift from inpatient to outpatient settings.”
Compared to a year ago, UPMC Health Plan enrollment increased from 4 million to nearly 4.5 million members — a 9% surge — due to the growth across many products, including Medicare, behavioralhealth and the statewide expansion of the Medicaid physical health managed care organization.
Improving Access to Primary and Advanced Care Where it is Needed
UPMC’s nearly $1 billion in capital expenditures during the year included the new UPMC Mercy Pavilion, set to open in spring 2023, and the new UPMC Presbyterian Tower, slated to open in 2026. In other regions, UPMC invested in advanced specialty care to more local communities, such as new UPMC Hillman Cancer Centers in Somerset, Hanover and Butler; UPMC Magee-Womens Specialty Services in Williamsport and Erie; heart and vascular services at UPMC West Shore and UPMC Jameson; UPMC Children’s at UPMC Harrisburg and Carlisle, and several other new outpatient multi-specialty care centers.
Additional new clinical programs include robotic bronchoscopy at UPMC Altoona, interventional stroke care at UPMC Harrisburg, a wound care center at UPMC Bedford, inpatient rehab at UPMC West Shore, and UPMC Western Behavioral Health at Twin Lakes near UPMC Somerset, expected to open in early 2023. UPMC also ramped up enhancements for data analytics, information technology and infrastructure to maximize use of resources to improve the consumer experience across the spectrum of care.
Expanding Insurance Services
“UPMC’s successfully integrated provider-insurer model enables us to be strong and nimble in fulfilling our mission of always providing the very best, value-based clinical care where it is needed, even during challenging times,” said Diane Holder, president and chief executive officer of UPMC Health Plan.
As the nation’s second-largest provider-owned health plan, UPMC Health Plan continues to earn national recognition for clinical quality and value. In 2022, the Pennsylvania Department of HumanServices awarded UPMC for You a Medicaid contract to serve all five Physical HealthChoices zones across Pennsylvania. Earning a coveted five star Medicare rating from the Centers for Medicare and Medicaid Services (CMS), UPMC for Life maintains its position as market share leader in western Pennsylvania for both its Medicare Advantage Individual and Special Needs plans.
Community Care Behavioral Health, the largest nonprofit behavioral health managed care organization in the nation, marked its 25th anniversary last year by earning contracts with two additional counties, now serving more than 1.5 million people in 43 Pennsylvania counties. UPMC Community HealthChoices, which coordinates physical care with home and community-based support, reached its highest enrollment level since the state Department of Human Services launched the program five years ago.
Adding seven counties in eastern Pennsylvania in late 2022, UPMC for Kids CHIP plan now provides coverage to children in 64 of Pennsylvania’s 67 counties. UPMC Health Plan’s family of government related lines of business are operating statewide. Through Pennie, Pennsylvania’s state-based health insurance marketplace, UPMC Health Plan enrolled over 31,000 new members and retained 93% of its existing membership.
Meeting Community Needs
UPMC provided more than $1.5 billion in IRS-defined community benefits during the last fiscal year, not including UPMC’s expenditures related to COVID-19. Notable investments in 2022 included the new UPMC Health Plan Neighborhood Center in Pittsburgh’s East Liberty neighborhood, where individuals can access virtual health consultations via UPMC Health Plan’s AnywhereCare telehealth platform, workforce development programs and social services from UPMC’s many community partners; Second Avenue Commons, a new homeless shelter in Uptown Pittsburgh for which UPMC provides free clinical care; a renovated and redesigned Matilda H. Theiss Health Center in Pittsburgh’s Hill District; the UPMC Street Medicine program, serving homeless individuals in the Harrisburg area; and the new Graham Park, supporting health and fitness programs for neighbors near UPMC Passavant. UPMC also completed its triennial Community Health Needs Assessments to identify and robustly address the most pressing needs in every corner of all the communities UPMC serves.
The UPMC Health Plan Center for Social Impact continued its leadership in helping to break down barriers to affordable, stable housing by expanding its successful supportive housing program,Cultivating Health for Success, to Blair and Lawrence Counties. The center implemented new community partnerships to help expand the reach of the Emergency Rental Assistance Program and collaborated with Rebuilding Together Pittsburgh to provide home repairs for individuals in need. In addition, UPMC’s model Pathways to Work program implemented new training program and apprenticeship models while continuing to recruit, train and hire an average of 200 Medicaid members per month. As part of this commitment, UPMC and UPMC Health Plan also secured state funding to expand the highly successful Freedom House 2.0 community first responder job training program into three additional regions in the state.
Investing in Employees
Amid staffing challenges over the past two years, a major part of UPMC’s $300 million investment in its dedicated workforce during 2022 has been the development of innovative programs that focus on retaining, recruiting and building a workforce pipeline. In early 2023, UPMC announced its commitment to increase the minimum wage for non-union employees to $18 an hour by 2025 for Pittsburgh (urban) and Central/North Central hospitals and associated facilities. Starting salaries at all UPMC’s other sites across Pennsylvania, New York and Maryland will reach $18 an hour by 2026. With this commitment, UPMC will again offer the highest entry-level pay of any health care system in Pennsylvania.
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