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acadian_cajun OP t1_j1v49bl wrote

TLDR: UPMC insurance is withdrawing coverage from dozens of small-scale pharmacies, forcing people in rural areas to either travel great differences to chain pharmacies like CVS, or to use partner Express Scripts to get prescriptions in the mail.

UPMC Mercy literally saved my dad's life last week during a major health emergency, but this pattern of monopolistic control just isn't good for anyone.


Ok-Twist921 t1_j1vevf3 wrote

The workers did what workers do (save lives) and the sociopaths in suits are doing what they do. It’s terrible.


acadian_cajun OP t1_j1vgzwn wrote

There was hundreds of millions worth of research and tens of millions worth of equipment that went into the procedure— society needs both good conscientious workers and complex systems, but we also need to be aware of tumors in the systems so we can untangle them.


pghgreatest t1_j1xcuy1 wrote

The whole system is set up without transparency on purpose so people can’t understand/follow where all the $ goes


coatedingold t1_j202k1g wrote

CVS is actually one of the pharmacies being dropped.


sophias_bush t1_j1v3dcv wrote

Fuck UPMC.

That’s all that needs said.


psycho_bunneh t1_j1yaln6 wrote

I still remember when Highmark and UPMC were feuding about pricing and UPMC was like "Look either do what we want or we'll just start our own insurance company." And Highmark went "Oh yeah?! Well then we'll...uh....start our own....whole hospital chain...I guess."

So of course they're going to keep monopolizing everything by vertically integrating everything related to health care.

Next, a few of the UPMC urgent care places will have in house pharmacies and you won't even be allowed to use CVS. That's how my last insurance company/hospital network handled things. 3 pharmacies for the whole city and they closed at 5, enjoy.

And yes, fuck them.


ThatKaylesGuy t1_j1v4c14 wrote

I used to have my prescriptions shipped to me by the pharmacy that occupies the other half of my PCP's building, but got that same letter that UPMC stuck some stupid deal. So I'm back to Rite Aid, where they only actually have the medication half of the time I go to pick it up. Basically, fuck big corps in general.


[deleted] t1_j1vxpmm wrote



Edmeyers01 t1_j1wl4cz wrote

Upvote this to the top! This is the biggest “fuck you” to UPMC that ever existed.


IceNineFireTen t1_j1xi2o0 wrote

I’m all for it, but FYI it’s an FU to pharmacies and drug manufacturers if anything. UPMC doesn’t care if you want to pay out of pocket for your meds. They probably prefer it.


BetesBurgh t1_j1v88ex wrote

Fuck UPMC and especially fuck Express Scripts, who, despite having literally one job, is utterly terrible at doing that job.


jaygibby22 t1_j1wh9s4 wrote

I’ve complained to my state rep and senator about this because my pharmacy is set to lose a large portion of our patients, some of which have been coming to my pharmacy for 20-30 years. The pharmacies they are being sent to have unpredictable hours due to staffing shortages and are known for poor customer service. This was not a decision made by our pharmacy. When we (and other pharmacies) reached out to UPMC to get back in network, they offered a contract where we would get paid less than the cost of the medication for a large number of drugs. Their options are literally lose business because you are no longer preferred or lose money because they won’t even pay for the services we provide.


Kyliep87 t1_j1xie0s wrote

Can you DM me your pharmacy name if it’s in the south hills? I may be switching pharmacies. Thanks!


jaygibby22 t1_j1yr985 wrote

Unfortunately, I’m from the Altoona area and can’t be of service for you. I would typically suggest checking out independent pharmacies or grocery store pharmacies. You’ll tend to get better service there.


Kyliep87 t1_j1zn8at wrote

Yes for sure. I go to my current pharmacy because my friend from pharmacy school is the manager there - makes life easier. But I really should support an independent pharmacy.


DannyLameJokes t1_j1v98zs wrote

I just got a $450 bill for a 10 minute appointment where the doctor wrote a prescription for a drug after I told him didn’t work for me. It took me longer to find parking.

So echoing the FUPMC sentiment


dpo466321 t1_j1vi689 wrote

Oh I was concerned I'd miss today's "fuck UPMC" post.... Anyway.... Fuck UPMC


[deleted] t1_j1v9sve wrote

Want to plug Blueberry Pharmacy in West View. They do mail Rx I think to the whole state (and in-person if you want to go there). No insurance.

If the prescription is generic it can be crazy cheap.


Jonny_Thundergun t1_j1vrlqn wrote

This is happening all over America. Video game companies can't merge but the medical industry can be a complete monopoly.


PGHthrowaway393 t1_j1v87nx wrote

I work for UPMC and they keep pushing us into offering a home delivery service called Mosaic Pharmacy to our patients. It’s such bullshit.


[deleted] t1_j1vs2p6 wrote



AlleghenyCityHolding t1_j1w18jy wrote

PORTLAND, ME. – October 5, 2016 – RxAnte, a leading provider of solutions that improve the use of prescription medications, announced today that it has received a growth equity investment from UPMC Enterprises. Under the terms of the transaction closed on Sept. 30, Millennium Health sold its entire interest in RxAnte, which will continue to operate as an independent company, led by its existing management team.

"Mosaic combines technology with a comprehensive clinical care model to create outcomes unlike other pharmacies. Therapeutic Decision Support™ (TDS), powered by RxAnte’s analytics, helps Mosaic pharmacists optimize our members’ medication regimens. Supported by this technology, we can better coordinate with prescribers to add, remove, or change medications to maximize therapeutic effect, while ensuring the patient is paying the lowest possible copays for their medications."


PGHthrowaway393 t1_j1w15v9 wrote

I think you’re right every time we have a meeting on it a UPMC employee is the one in charge of the meeting


IAmMostDope92 t1_j1w5s0k wrote

Idk how you can work for them. Assuming you’re on the phones, I almost had a mental breakdown myself after 3 months. Fuck them.


PGHthrowaway393 t1_j1w73un wrote

I’m not telephonic I’m a social worker so it’s not strict phones all day.

But to answer your question I don’t know how I can work for them either I hate it here


Collins71514 t1_j22p3zd wrote

Same, I did 3 months in the cardiac dept and I couldn’t do it anymore, I went to a private practice after that. It’s insane how much bullshit goes on behind closed doors, they way they treat their own is just out of this world awful.


IAmMostDope92 t1_j24cm57 wrote

Pretty sure they stalk their employees and spy on them too.


PierogiPowered t1_j1vlky1 wrote

Coulda stopped the title at "UPMC is using monopolist tactics"


pghdadbod73 t1_j1wd5mp wrote

Cmon they are a non profit that reaps huge profits


1stCaptainSkrall t1_j1wr022 wrote

The writing for this has been on the wall for a long time. Seems like every year some small insurance company is swallowed by UPMC or Highmark. Then the ones they can't buy go under because they can't compete with the rates offered by the other two.

You watch, in another 10 years they'll carve out small kingdoms of exclusive insurance in the same way the ISP's did with their service areas. "Oh you want to go to this hospital? Too bad, its in Blue Team's network, and you're Red. Drive 45-60 minutes to the nearest Blue Team hospital."


Strongbow85 t1_j1xrxsa wrote

UPMC may be the most cutthroat "non profit" the health sector has ever seen.


NoSwimmers45 t1_j1ygfnt wrote

I’ve been fighting UPMC’s insurance arm for months over a claim they won’t fully explain. At this point I’ve cost them more in salary, cost of their 800-number, postage and office supplies than the claim they’re avoiding explaining. I refuse to give up until they do explain. I’ve opened a complaint with the State Insurance Department. If I “lose” again my next stop is the AG and perhaps my state reps. Last resort is taking the absurdity to the news. Fuck UPMC!


Buttercupia t1_j1xeirn wrote

My great local non profit community pharmacy is getting hosed by this. (Lost and Found pharmacy in Penn hills, they’re great and they do compounding)


MeanLawLady t1_j1x89lu wrote

And we can’t do anything about it.


maaaaaan412 t1_j1z8b4m wrote

PBMs and insurance companies have been squeezing pharmacies for many years and this is just another method to do that. I can’t believe any independent pharmacies can stay open at this point. Even big box stores are losing their asses on pharmacy nowadays.


DickNose-TurdWaffle t1_j1w2tv6 wrote

I hope these businesses come together and get a good lawyer. Sounds like monopolistic practices.


helloiamaudrey t1_j1y6r76 wrote

Listen I consider a difference between UPMC Hospitals and UPMC insurance (idk about the paid insurance, I have state insurance through UPMC and it’s great),


zeroes_and_ones_ t1_j1ywvbt wrote

Both the insurance and the hospitals are run with cutthroat precision and with one goal in mind, making money.

I worked somewhat closely with CCBH, which is the managed care organization for mental health services for people who are covered by UPMC insurance. They have employees whose whole job is to study which services they're losing money on and how they can avoid approving that service for patients.


halfNelson89 t1_j1zv2pt wrote

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.


waitforit55 t1_j1vjrie wrote

Express scripts is an awesome company though. Great customer service, easy to use app and easy to schedule.


iamnotyrmotheriswear t1_j1vsrib wrote

*This message brought to you by Express Scripts


waitforit55 t1_j1vv14b wrote

I have to use them as im in the Army. They've been good to me and my fam. 🤷🏻‍♂️


iamnotyrmotheriswear t1_j1vxlmt wrote

Thanks for your service


iamnotyrmotheriswear t1_j1xipdy wrote

I'm getting downvoted for thanking someone for being in the Army. Wtf is wrong with people?


just_an_ordinary_guy t1_j1xndtt wrote

Because we're tired of the military worship. And as a veteran who hated his service because the military is a toxic and bullying workplace, I hate when people thank me for my service. Didn't downvote you, just explaining two possible reasons.


iamnotyrmotheriswear t1_j1xpb6z wrote

Saying thanks is worship?


just_an_ordinary_guy t1_j22oxoq wrote

The whole "thank you for your service" thing people do to military members is part of soldier worship, yes. You don't know who they are or what they did. Maybe they're a giant shitbag.