UPMC posted a $1.1B loss the first 9 months of ‘22. Their insurance product is BY FAR the most affordable option out there. They have to generate revenue and advance a patients recovery from the entire episode of care to keep their prices low and improve outcomes.

Sure they do things like spend millions on advertising and building renovations that contribute to the loss, but this vertical integration is the future of healthcare. At least with CVS and express scripts, you know exactly what the pharmacy is charging and what your out of pocket will be.

Next step will be manufacturing their own generic or brand name medications.

Healthcare is so complicated because reimbursement is shrinking, it’s being tied to patient outcomes. They need a way to make sure you’re taking your meds, doing your PT, following your dietary advice, etc., because when you don’t and your hip replacement fails or your infection comes back, insurance won’t pay for your readmit.

I hate UPMC, but this isn’t shocking and honestly it will improve the patient experience. My money is on Cleveland Clinic or Geisinger merging or buying Allegheny health and doing the exact same thing that UPMC is doing.