Geisinger, Highmark pursuing joint venture on new care model

Geisinger Health System and insurer Highmark have signed a letter of intent for a new joint venture to develop a new clinical network and reimbursement in four Pennsylvania counties.

According to a joint press release, their intent is to “creating a clinical network that is patient-focused, physician-oriented and community-based,” with access offered to members of Highmark and Geisinger health plans, including those in Medicare Advantage plans.

“Highmark and Geisinger are recognized and trusted names in health care, and we have long collaborated to provide our members with access to the high-quality care provided by Geisinger's hospitals and physicians,” Highmark President Deborah Rice-Johnson, said in a statement. “Our joint experience in care delivery and care management can help to advance value and affordability. Working more closely together, we can bring innovative, consumer-centered care models to the community.”

While the details of the venture were left vague, the companies mentioned the model will involve using “a network of community-based sites,” including building a new health campus in Montoursville, Pennsylvania. The ultimate goal of the model is to offer a more efficient and effective care model over traditional inpatient and outpatient hospital visits.

“The goal of this new facility will be to deliver important medical services and clinical capabilities in the local community that are complementary to the advanced tertiary services available at Geisinger Medical Center,” said Lynn Miller, Geisinger’s chief administrative officer of clinical enterprise. “We are currently assessing community needs and levels of appropriate investment to meet those needs.”

The move could be seen as a reaction to the expansion of University of Pittsburgh Medical Center (UPMC), the largest health system in the state. In the past year, UPMC acquired the four-hospital Susquehanna Health system and secured an affiliation with Harrisburg-based PinnacleHealth.

“We want to make sure that there is value-based access for our members,” Rice-Johnson said on a conference call with reporters, according to Pittsburgh Post-Gazette, adding that “we know what UPMC has done in the past, and that is increase costs.”