Local officials in the state’s Steel City have set their sights on more affordable, equitable health care as one of the largest health systems in the nation brings in new leadership.
The University of Pittsburgh Medical Center (UPMC) announced last week that Leslie Davis will succeed Jeffrey Romoff as president and CEO of the health system. Davis officially assumed the role Monday as Romoff’s retirement took effect at the end of July. Davis, the former executive vice president, brings more than three decades of health care operations and business experience to the role.
While Romoff’s tenure at UPMC was one of substantial growth and expansion, it was also one of controversy. State Rep. Dan Frankel, a Democrat who represents the Squirrel Hill area, released a statement saying UPMC can build a better future now that Romoff’s reign is ending.
“For too long, UPMC has used its strength and expertise to extract from our community -- whether that’s the labor of employees who had to rely on the hospital food banks, the silence of doctors fearful of speaking out in case they lost their jobs, or the hard-earned dollars of patients desperate for care,” Frankel said in a statement last week. “Perhaps now the institution can become the leader it promised when it posted its logo in the brightest possible lights on top of the Steel Tower: Stop taking and start giving back.”
Romoff had worked at UPMC since 1973 and led its expansion from six hospitals and about 500 employees to 40 hospitals and more than 92,000 employees. “We transformed the economy in Western Pennsylvania and turned the world’s eyes to Pittsburgh as a hub of medical innovation and groundbreaking patient care,” Romoff said in a note to employees. “With a strong growth trajectory and best in class teams, we are now at a period of both stability and success at UPMC.”
The now-$23 billion hospital network has acquired more than 14 hospitals within the last five years, consolidations that some say make it harder for consumers to maintain affordable access. His tenure was also home to several lawsuits related to the system’s contract negotiations, insurance pricing and union-busting.
Pennsylvania Attorney General Josh Shapiro got involved in the lawsuit between UPMC and Highmark to keep UPMC from ending its business relationship with the insurance provider. After becoming an integrated health system, one that provides both care and insurance, UPMC spent years trying to stop accepting Highmark insurance, a direct competitor, in order to boost enrollment in its UPMC Health Plan.
“I basically viewed this as an attempt by UPMC to disenfranchise hundreds of thousands of people in Western Pennsylvania and beyond, from having access to their hospitals and providers,” Frankel told City & State. “All of this stuff, whether it was manipulation of the reimbursement system, whether it was trying to basically disenfranchise people from their providers and build up their own health plan, was all part of a business plan being propagated by an organization that is a nonprofit by state law.”
Antoinette Kraus, executive director of the Pennsylvania Health Access Network, said the dispute between UPMC and Highmark was “egregious.”
“We heard from cancer patients who were worried they no longer have access to their doctors or heart patients are worried about losing access to their cardiologist,” Kraus told City & State. “We really wanted UPMC to listen and be a good partner, but they just did not seem interested in the demands and the pleas of everyday Pittsburgh residents.”
UPMC has also been called out for predatory billing in the past. A study conducted by Axios, in partnership with Johns Hopkins University, found that many of the nation’s top revenue-generating hospitals are perpetrators of price markups. UPMC’s Presbyterian hospital was found to be sixth for price markups, and first among nonprofits.
At the time the study was released, UPMC claimed it did not recognize the data from the report, and that it was not reflective of the entire UPMC system. When City & State asked about this, UPMC could not be reached for comment.
Kraus also cited polling data that showed an increasing number of Pennsylvanians are struggling with high health care costs, particularly residents in the southwest part of the state.
Frankel, Shapiro and others have said UPMC’s status as a public charity is a manipulation of the law. Frankel also said he repeatedly urged his colleagues in the legislature to regulate health networks, and has introduced two bills that would create “a system for fair contracting” with hospital systems and provider networks.
“This is the kind of environment Jeff Romoff exploited,” Frankel said. “And in my view, they have been kind of the poster child for some of the most significant abuses and distortions that we have in our health system in the United States.”
Pittsburgh Controller Michael Lamb agreed that UPMC hasn’t lived up to the promises it made in the past, noting that it took employees years to get the health system to fulfill its goal of increasing its minimum wage to $15.
“The fact that we had to fight for that was a shock,” Lamb told City & State. “The organization is benefiting from a tax exemption because of what they call their charitable status, and yet they’ve been ruthless when it comes to the formation of a union there. That doesn’t seem particularly charitable.”
Frankel, Lamb, Kraus and others emphasized how much UPMC contributes to the region and state. They recognized its innovations in the health care field are a tremendous asset, but they also recognize the system, as a whole, can shift more of a focus back to the consumer.
“I've been accused over the years of wanting to destroy UPMC. That would be the dumbest thing in the world. I want UPMC to be reformed,” Frankel said. “I think Leslie Davis, someone who I know, could be a breath of fresh air in a new beginning...That is more consistent towards supporting our community the way it deserves to be supported.”