Highmark asks patients to ‘Meet Dr. Right’

Adam Smeltz, The Pittsburgh Tribune-Review

April 18--Tennille Simonson needed to find a new doctor.

She had lost in-network access to her primary care physician at UPMC, their relationship a casualty of disintegrating ties between the hospital system and her insurer, Highmark Inc.

Then arrived the invitation: a speed-dating-style event at which Simonson could nibble hummus and mingle with 22 primary care doctors and specialists. She could handpick a compatible doctor based on insurance and easy access -- and perhaps even their charm.

"It's great because you get to meet doctors in person and get a sense of their personality and their bedside manner," said Simonson, a physical therapist from Cranberry who attended a "Meet Dr. Right" event this week sponsored by Highmark and Allegheny Health Network. About 250 people turned up at the event, held at the Wexford Health + Wellness Pavilion off Route 19.

The dominant insurance company and its health care system plan several more gatherings through the summer, a targeted approach to cultivate business and foster primary care as Western Pennsylvanians navigate a recast insurance landscape.

"You need to make sure you're comfortable with your doctor," said Simonson, who lingered near a bowl of fruit punch. She planned to make an appointment after the three-hour shindig.

"A lot of people I know avoid going to a doctor because they're uncomfortable and put it off."

About 20 percent of the attendees late Thursday scheduled appointments that evening, delighting Highmark and Allegheny Health officials who choreographed the affair with a playful touch. Colorful pamphlets listed short biographies of the doctors on hand, whose spotlighted hobbies range from competing in triathlons to making buffalo chicken pasta. One male doctor described himself as a model while in graduate school.

Inside the 175,000-square-foot pavilion that opened in October, visitors had their pick of high-end cheeses, salsa, even a healthy cooking demonstration that featured Cajun salmon. Doctors in white coats milling casually around tall, rounded tables lent a cocktail-party vibe as would-be patients chatted them up.

Organizers allowed walk-ins but sent invitations specifically to Highmark customers living in a 10-mile radius of the pavilion, a medical mall that houses preventive, diagnostic and therapeutic care under one roof.

Pavilion President Jeffrey Carlson said the speed-dating style, used by other medical systems across the country, is a perfect fit as Allegheny Health introduces the pavilion and local patients work through insurance changes. He was not sure how many of the event invitees Thursday were Allegheny Health customers.

"It shouldn't be a decision that goes lightly for somebody to select a primary care provider," said Carlson, who called the relationships critical to health care. He said sustained coordination and communication between a patient and a primary care doctor can help prevent illness and keep long-term health care costs in check.

Health policy analysts expect the growing rift between Downtown-based Highmark and UPMC, the largest hospital system in the region, will nudge many Western Pennsylvanians to switch insurance plans or physicians. The companies on Dec. 31 let expire a longtime commercial contract that gave Highmark subscribers expansive in-network access to rival UPMC.

Fallout began emerging in February, when Highmark disclosed its regional market share had fallen to 60 percent from 63 percent over 2014. The company has said it needs to boost admissions in the West Penn Allegheny Health System, a cornerstone of Allegheny Health, in order to improve the system's financial standing.

UPMC said it offers after-hours primary care, extended-hours offices, a friendly call center and other services to help people meet doctors. Speeding dating-type events are not on its list, UPMC spokeswoman Wendy Zellner said.

"As the area's only medical center with system-wide electronic medical records, we know you and can instantly connect to your records and doctors and their care when you need it," she said.

Hospital systems across the country have big incentives to make matches between patients and primary care doctors, said David E. Williams, co-founder of the Health Business Group consulting firm in Boston. He said a good match over the long term can reduce the odds of severe ailments and avoidable medical bills.

"You get that only by meeting the individual," said Williams, who encouraged open conversation. "Good communications can keep a small problem from turning into a big one."

Adam Smeltz is a staff writer for Trib Total Media. He can be reached at 412-380-5676 or [email protected].

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