Amid Industry Challenges, UPMC Keeps Its Focus on Serving Patients, Members and the Community

By: Susan Manko

UPMC continues to lead the evolution of healthcare in a post-pandemic world by adeptly tackling the lingering challenges related to the pandemic that are affecting health systems across the nation. UPMC led in addressing unprecedented healthcare workforce shortages; improving access to care for those in need; assessing the healthcare and health coverage needs in our many diverse communities; and growing our clinical programs, community outreach and insurance services to meet those needs.

Meanwhile, UPMC continued its expansion internationally and forged ahead locally with its business and scientific innovations. These efforts keep UPMC continuously focused on shaping the future of healthcare by delivering high-quality services to patients and members.

Investing in and Supporting our Workforce

UPMC has invested over $300 million in support of its workforce throughout 2022. Amidst staffing challenges over the past two years, a major part of UPMC’s investment in its workforce has been in the development of innovative programs in 2022 that focus on retention, recruitment and building a workforce pipeline. By the end of 2022, more than 1,800 internal and external nurses had applied for the new UPMC Travel Staffing team; more than 1,400 graduate nurses were hired, attracted by the new Monthly Loan Repayment Program; and 150 new students have officially been accepted into the UPMC Schools of Nursing via the new Tuition Loan Forgiveness Program.

Other investments include extra shift bonus incentives to reward staff who take on extra shifts to support patient care and the My Nursing Career platform, which acts as a pathway to encourage and support career growth. In addition, UPMC opened several new schools of nursing and developed new strategic partnerships with various clinical specialty training programs at numerous colleges, universities and technical schools to provide affordable opportunities for new students to enter the healthcare field.

Improving Access to Care

During 2022, UPMC further extended its specialty services throughout all our regions with emphasis on meeting patient preferences by providing new models of high-quality care at lower costs, while improving on convenience by positioning itself closer to patients’ homes. Investments included 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 centers for primary and multispecialty care.

UPMC continued to broaden member access to telehealth services for its members. Community Care expanded access to behavioral services via telemedicine. UPMC also launched teledental services for Medicaid and Children’s Health members; these innovations resulted in exceptionally high member satisfaction levels for those who utilized the telehealth resources.

Advancing Clinical Specialty Services throughout our Regions

In 2022, UPMC placed the final beam atop the new UPMC Mercy Pavilion and broke ground for the new UPMC Presbyterian Tower within Allegheny County. These facilities are expected to open in the spring of 2023 and late 2026, respectively. In other regions, UPMC invested in advanced specialty care to more local communities, including 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, which is expected to open in early 2023.

Caring for our Communities

Reflecting on UPMC’s steadfast commitment to community service, UPMC provided more than $1.5 billion in IRS-defined community benefits during the last fiscal year. This is part of UPMC’s total community investment of over $4 billion, which includes local, state and federal taxes paid, unreimbursed Medicare costs and investment in facilities, equipment and technology. This total amount excludes UPMC’s expenditures related to COVID-19. UPMC’s $1.5 billion in community-focused programs last year equals $4.1 million per day, or nearly 15% of net patient service revenue. According to the most recent publicly available data, UPMC contributes more community benefits than any other health system in Pennsylvania.

UPMC opened 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.

Other notable investments in 2022 included Second Avenue Commons, a new homeless shelter in Uptown Pittsburgh for which UPMC provides free clinical care; the new Graham Park, supporting health and fitness programs for neighbors near UPMC Passavant; a renovated and redesigned Matilda H. Theiss Health Center in Pittsburgh’s Hill District; and the UPMC Street Medicine program, serving homeless individuals in the Harrisburg area.

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 by implementing new community-based organization partnerships to help expand the reach of the Emergency Rental Assistance Program and building a partnership with Rebuilding Together Pittsburgh to provide home repairs for individuals in need.

UPMC’s model Pathways to Work program implemented new training programs 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 health job training program into three additional regions in the state.

UPMC also completed its triennial Community Health Needs Assessments to identify and address the most pressing needs in every corner of the communities we serve.

Growing our Insurance Services

As the second-largest provider-owned health plan nationally, UPMC Health Plan continued to receive national recognition for clinical quality and value. During 2022, UPMC further grew its membership across its family of award-winning insurance products, which now serves nearly 4.5 million members. In 2022, the Pennsylvania Department of Human Services 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 continued to maintain 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; the program now serves more than 1.5 million individuals 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 Q4, UPMC for Kids CHIP plan now provides coverage to children in 64 of Pennsylvania’s 67 counties.

With this growth in 2022, 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 percent of its existing membership.

Expanding UPMC’s International Footprint

UPMC’s expansion continued globally in 2022, including the announcement of a new partnership in Croatia to create a UPMC Hillman Cancer Center, which would be UPMC’s first entry into that country. UPMC also saw the opening of a third cancer center in Italy at the UPMC-managed ISMETT transplant hospital in Sicily. Likewise, Community-focused growth continued in Ireland with the addition of new UPMC Sports Medicine clinics in Limerick and Tipperary and the first UPMC Institute for Health in Mayo. A new academic partnership with University College Cork will expand cancer research through the appointment of two UPMC-funded academic oncologists.

Driving Innovations through UPMC Enterprises

Shaping the future of healthcare through innovation remained a focus of UPMC’s during 2022, particularly through the investment and commercialization efforts of UPMC Enterprises. Among its Translational Sciences successes, portfolio companies Avista, Cerevance, CodeBio and Generian signed research partnerships or licensing agreements with large pharmaceutical and biotechnology companies that will advance development of their programs.

In Digital Solutions, UPMC created startups like Pip Care to advance perioperative patient care and licensed technology innovations like its Alexandria Charts unstructured data platform to Clearsense. The development of digital tools for UPMC’s patients was strengthened through a strategic partnership with and an investment in Kyruus, a provider search and scheduling solutions company, with the goal of providing patients with additional digital access channels and self-service tools.

Earning Recognition for our Commitment to Quality

Providing high-quality care remained a top priority in 2022. UPMC Children’s Hospital of Pittsburgh was recognized as one of the top pediatric hospitals in the nation, earning the sixth position on the 2022-23 U.S. News & World Report Honor Roll of America’s Best Children’s Hospitals. In the U.S. News America’s Best Hospitals survey, UPMC Presbyterian Shadyside was nationally ranked in 9 adult specialties.

UPMC Magee-Womens Hospital was recognized as a 2022-2023 High Performing Hospital for Maternity Care (Uncomplicated Pregnancy) by U.S. News & World Report, while UPMC Harrisburg and UPMC Williamsport were also recognized as High Performing in Maternity Care. In addition, a significant number of hospitals received an “A” Hospital Safety Grade, the highest achievable safety mark, from The Leapfrog Group, a national organization that aims to improve healthcare quality and safety for consumers and purchasers.

UPMC Health Plan also received national recognition for clinical excellence and an unrivaled focus on Member Services. UPMC Health Plan earned 12 Stevie® Awards for Sales & Customer Service in 2022, competing with organizations of all sizes across almost every industry. UPMC for Life, earned a five-out of-five overall Star Rating for its HMO and PPO Medicare for medical coverage and member service delivery, and was similarly recognized by U.S. News & World Report as one of the “Best Insurance Companies for Medicare Advantage and Part D Prescription Drugs,” as well as receiving accreditation from the National Committee for Quality Assurance (NCQA). UPMC Health Plan was also among the first plans to earn the Health Equity Plus accreditation from the NCQA.