Workforce challenges in rural communities subject of public hearing

Workforce challenges faced by employers in rural communities were voiced by PA Chamber Director of Government Affairs Kevin Sunday this week in a public hearing hosted by the Center for Rural Pennsylvania. 

Held at Penn College, the hearing included participants from PA Chamber members, UPMC, University of Pittsburgh, Penn State, Coterra Energy, Shippensburg University, and Penn College. Leaders from Pennsylvania’s energy and healthcare sectors along with agency officials, educators, and nonprofit associations were also on hand. 

Sunday testified on workforce challenges in rural communities, highlighting the importance of improving Pennsylvania’s economic competitiveness through favorable tax and regulatory policies. He said the PA Chamber’s goal is to make Pennsylvania the most economically competitive state in the country. 

“This requires a tax and regulatory environment that encourages investment into the state,” Sunday said in a release. 

Sunday emphasized the need to support economic growth across Pennsylvania through modernized infrastructure. 

“We need modernized infrastructure across the state – from a safe and efficient system of roads and bridges to world-class airports and ports, to reliable gas, electric, and water infrastructure, and, just as important, access to high-speed broadband,” he said.

Sunday restated the chamber’s support for efforts to improve Pennsylvania’s workforce by addressing key issues such as affordable childcare, occupational licensing requirements, re-entry into the workforce following incarceration, and childcare for working families.

Noting Pennsylvania’s population decline, Sunday called for policymakers to focus on creating an environment in the state promotes population growth and attracts investment. Citing IRS data showing that businesses and citizens are leaving Pennsylvania for states with better economic climates, he urged a close look at regional economic needs and population migration trends.

“Reforms to the state’s tax and regulatory structure help everywhere,” said Sunday, “but it is certainly the case that each region of the state has its own key industries.”

Sunday reiterated the PA Chamber’s commitment to working with the Shapiro Administration, state legislature, local communities, and other key stakeholders to deal with Pennsylvania’s workforce challenges.

UPMC president and CEO to leave role after 15 years

Pittsburgh-based UPMC’s president and CEO of 15 years is set to step down from his position next week after 48 years with the health system—he will be succeeded by Leslie Davis, a health care executive with 17 years of experience at UPMC.

Jeffrey Romoff, attributed with growing the $23 billion network of 40 hospitals to become the largest non-governmental employer in Pennsylvania, will leave the role he has held since 2006 on Aug. 1.
With Romoff at the helm, UPMC has expanded across Pennsylvania with the acquisitions of regional health systems such as Susquehanna Health and Pinnacle Health and into New York and Maryland with the acquisitions of WCA Hospital in Jamestown, New York and Western Maryland Health System in Cumberland, Maryland.

“Under Jeff’s leadership, UPMC has provided excellent and unmatched health care across our tri-state service territory and internationally. He has led UPMC in developing new models of care and supported advanced research that has benefitted our patients,” said G. Nicholas Beckwith III, chair of the UPMC Board of Directors. “Jeff’s contributions are numerous in helping to build UPMC into the global health care leader that it is today. The full Board of Directors joins me in recognizing Jeff’s accomplishments, including the establishment of a strong foundation for the advancement of patient care, research breakthroughs and developing the overall vision for UPMC’s growth.”

Romoff will remain with UPMC as president emeritus, acting as a resource for incoming president and CEO Leslie Davis.

Davis, president of the Health Services Division at UPMC and former president of UPMC Magee-Womens Hospital from 2004 to 2018, joins the role after 30 years of health care experience.

As president of Health Services, Davis has been responsible for leading UPMC’s operations across its portfolio of hospitals and has played a large role in positioning the system as a national health care innovator, the system wrote in a statement on Wednesday.

“She brings a stellar track record built over three decades of leadership in health care with the background and expertise to help propel UPMC into the next phase of growth,” said Beckwith. “In her 17 years at UPMC, she has demonstrated a strong commitment to clinical excellence and very strong relationships with our patient families, physicians, employees, leaders and communities.”

Prior to joining UPMC, Davis was president of Graduate Hospital in Philadelphia and began her career at Mt. Sinai Medical Center in New York City.

“I look forward to continuing to ensure that health care is accessible and affordable to our communities while driving innovation, employee engagement, academic excellence and research across all of our hospitals and practices,” said Davis. “I am confident in our organization’s future and look forward to continuing to serve our patients, our members, our employees and our communities as UPMC soars to even greater heights in the future.”

Pennsylvania begins coronavirus testing prior to first case

The Pennsylvania Department of Health has begun testing potential samples of coronavirus from its Exton-based laboratory, but has yet to see an active case in the state.

The Centers for Disease Control and Prevention (CDC) shipped tests to state departments of health across the country this week after two months of testing potential samples of the virus from its own facilities.

With the update in the CDC’s guidelines, Pennsylvania’s Department of Health has been able to test any potential samples of the virus that state health care organizations send its way — a change that Pennsylvania Secretary of Health Dr. Rachel Levine said could speed up wait times for testing from two to three days to less than one day.

“This is a very important step for us as we continue to provide timely updates to Pennsylvanians,” Levine said during a press conference on Tuesday. “If we get a specimen in the morning, we can have (a result) later in the afternoon.”

The CDC announced late last month that coronavirus had grown to over 80,000 cases worldwide, with more than 2,700 deaths documented. The most recent numbers in the U.S. are currently at 108 cases with nine deaths.

While Pennsylvania has yet to see its first case of the virus, the state is already testing samples sent to it from health care providers and can currently test six samples per day, said Levine.

The CDC said that it will be sending additional equipment to states to increase the number of tests departments can do in one day.

The U.S. Food and Drug Administration has also announced that it will soon open up testing to commercial laboratories.

Dr. Graham Snyder, medical director of infection prevention and hospital epidemiology at UPMC in Pittsburgh, said during a press conference on Tuesday that the hospital system is already preparing to perform testing.

“We are working quickly to develop our own testing capabilities so that any cases can be identified more rapidly,” Snyder said. “As an organization, we’ve had system-wide communication, whether staff are in a rural hospital or in Pittsburgh.”

Some manufacturers of medical devices based in China have seen disruptions in their production lines because of the coronavirus outbreak, but Tami Minnier, Chief Quality Officer at UPMC, said that the system has yet to feel any pressures in their supply chain partnerships.

“We are not sitting back and waiting for any of those pressures to come to us,” Minnier said. “We are proactively working with those suppliers and vendors.”

New hospitals join Pennsylvania’s Rural Health Model

Pennsylvania Department of Health Secretary Dr. Rachel Levine announces the first rural hospitals to take part in the state’s Rural Health Model in March. PHOTO/ IOANNIS PASHAKIS

Eight more hospitals across the state will be joining a state initiative created to help rural hospitals receive the funding they need to stay open.

This March, the Pennsylvania Department of Health launched its Rural Health Model, a payment model that asks insurers to pay hospitals through fixed monthly payments instead of by patient.

Hospitals are commonly reimbursed by insurers through a fee-for-service model where the insurer pays the hospital each time a patient visits. For hospitals operating in rural populations with unpredictable admissions, the lack of funding during slow periods can end in closure.

In the program’s initial rollout, five insurance companies agreed to change their funding model for five Pennsylvania hospitals.

The department announced on Thursday that eight more hospitals have been approved for the program and Hartford, Connecticut-based Aetna has agreed to join the program as its sixth insurer.

“The Rural Health Model is a transformative step that changes the financial model for hospitals in rural areas,” Secretary of Health Dr. Rachel Levine said. “This is a step that will help achieve financial stability for these facilities and aims to improve the overall health of the community.”

The newest hospitals joining the model include: Armstrong County Memorial Hospital in Armstrong County, Chan Soon-Shiong Medical Center at Windber in Somerset County, Fulton County Medical Center in Fulton County, Greene hospital in Greene County, Punxsutawney Area hospital in Jefferson County, Tyrone Hospital in Blair County and Washington Hospital and Monongahela Valley Hospital in Washington County.

Insurers pay the hospitals based on how much they paid the hospitals when they were using the fee-for-service model. Aetna will be joining the program along with Gateway Health Plan, Geisinger Health Plan, Highmark Blue Cross Blue Shield, Medicare and UPMC Health Plan.

The department plans to grow the model from 13 hospitals to 30 by 2021 with the ultimate goal of bringing all of Pennsylvania’s 67 rural hospitals under the model.

UPMC to cut ties with Highmark after court ruling

Pennsylvania Commonwealth Court ruled on Friday that Pittsburgh-based UPMC can stop accepting Highmark Health-insured patients by the end of the month.

The ruling is part of an ongoing argument over the end date of a consent decree between the Office of the Attorney General, UPMC and Highmark Health.

Attorney General Josh Shapiro took UPMC to court this week in the hopes of extending the terms of a 2014 consent decree. The decree gave the systems a five-year transitionary period leading up to June 30, 2019 at which point UPMC would stop accepting patients insured by Highmark.

The state’s Commonwealth Court sided with UPMC, meaning that the health system can finish its transition away from its former partnership with Highmark and its providers will stop accepting the insurer on June 30.

Shapiro said that the split would harm the many Pennsylvanians insured through Highmark that rely on UPMC for their health care.

“Make no mistake, our work here is not done,” Shapiro said in a statement Friday. “While we are disappointed in Judge Simpson’s ruling, I won’t quit on the people of Western Pennsylvania and we will continue to take steps to restore fairness to the healthcare system and give people access to the institutions their tax dollars built.”

Shapiro and his office argued that a provision in the decree allowed for changes in the contract that could be used to rewrite the end date to continue indefinitely.

Commonwealth Court had ruled in April that the consent decree could expire as scheduled on June 30. The Office of the Attorney General appealed the court’s decision, arguing that the decree should be extended because of the modification provision.

Late last month the appeal was heard by the Pennsylvania Supreme Court, which ruled 4-3 in favor of Shapiro, allowing the case to be heard once again in Commonwealth Court. In the Supreme Court’s majority opinion of the case, Justice David Wecht wrote that the Attorney General had the right to have the case heard again in Commonwealth Court, utilizing the modification provision as evidence.

“Given the unbounded language of the Modification Provision, seasoned counsel likely foresaw, or should have foreseen, the possibility that significant alterations might be requested,” Wecht wrote.

Judge Robert Simpson of state Commonwealth Court did not agree with the Supreme Court’s decision and instead claimed that given UPMC’s consistent attempts to try to end its partnership with Highmark, there was no reason to believe that UPMC would have agreed to something that could have made the relationship indefinite.

“The general provision does not include any express limitation; nevertheless, there is no believable evidence that any party intended the general modification provision to override the specific termination/expiration provision which had been the subject of negotiations almost from the beginning,” Simpson wrote.

UPMC released its own statement regarding the ruling, noting that the system was pleased with the court’s decision.

“UPMC is grateful the Commonwealth Court expeditiously reached this decision. We look forward to continuing to fulfill our long-standing charitable mission and serving the public with UPMC’s world-class physicians and facilities,” the system wrote.

Shapiro could still appeal the court’s ruling in the Pennsylvania Supreme Court and said in his statement that his office will be announcing subsequent legal steps next week.

Top court allows UPMC-Shapiro fight to continue

UPMC and Pennsylvania Attorney General Josh Shapiro are heading back to court in their battle over a consent decree requiring the Pittsburgh-based health network to take patients insured by Highmark Health.

The Pennsylvania Supreme Court on Tuesday reversed a lower court’s decision that would have ended the consent decree on schedule on June 30. Shapiro is fighting to have it extended indefinitely.

But the decision was not unanimous. The court ruled 4-3 in favor of Shapiro, finding fault with the reasoning of the Commonwealth Court. The ruling does not mean the decree will be extended, only that Commonwealth Court will have to rehear the case.

A date for a hearing has not been announced.

“As directed by the Supreme Court, my office will now make our case in Commonwealth Court on an expedited basis that modification of the end date is not just permitted — but necessary to ensure UPMC fulfills its role as a public charity and isn’t able to shun the very taxpayers whose tax dollars built their business,” Shapiro said in a statement.

UPMC was not immediately available to comment on the ruling.

The Supreme Court justices split over whether and to what extent the decree between UPMC and Highmark could be modified. The majority agreed it could and that, based on the decree’s language, there were no limits on how.

“Given the unbounded language of the Modification Provision, seasoned counsel likely foresaw, or should have foreseen, the possibility that significant alterations might be requested,” Justice David N. Wecht wrote for the majority.

In a dissenting opinion, Justice Max Baer said he agreed with the majority that Commonwealth Court ruled incorrectly, but that the decree’s modification clause should be limited. He wrote that changing the end date from June 30 to “indefinite” is not a modification.

“I conclude that the ‘modification’ sought by the Office of Attorney General is not a modification at all but, rather, an attempt to seek judicial intervention to eliminate the termination date and impose upon UPMC a permanent injunction requiring that it remain tethered to Highmark indefinitely,” Baer wrote.

The consent decree was reached in 2014 after UPMC and Highmark fell out over Highmark’s purchase of Allegheny Health System, a rival health system to UPMC. UPMC said it would stop accepting patients insured by Highmark. The consent decree created a five-year transition period.