It might seem to some like the city's town hall meeting Tuesday to discuss UPMC's recent takeover of Altoona Regional Health System is like closing the barn door after the horse got away.
After all, the impetus for the meeting was a visit to City Council back on May 22 by SEIU Healthcare Pennsylvania registered nurses and others to air concerns when there was more than a month left to hold a meeting before the merger's July 1 effective date.
But that's not how to look at it, according to city Mayor Bill Schirf.
Yes, the city could have held the meeting before takeover.
But that wasn't going to prevent the takeover, and if the city waited a little, there would be questions hospital officials could answer that they couldn't with the merger still in abeyance, Schirf said.
City Councilman Dave Butterbaugh, who helped organize the town hall, cited an additional reason - the unavailability of local state lawmakers to attend before the end of June because of budget negotiations in Harrisburg.
"I purposely wanted to wait until they could take part," said Butterbaugh, adding that he never opposed the merger and mainly wants to open "the lines of communication" between the hospital and the community.
He wanted lawmakers to attend so they can explain what went on in Harrisburg in connection with the merger, he said.
According to hospital spokesman Dave Cuzzolina, the hospital didn't ask the city to postpone the meeting until after the merger.
Before the merger, hospital President Jerry Murray discussed "what would be gained" by such a meeting, given that "the merger was all but a foregone conclusion at that time," Cuzzolina said.
But it was Butterbaugh who called it off, he said.
The hospital wasn't involved in rescheduling, he said.
The biggest issue for the city is to be sure it can honor its contracts with employees who have Highmark insurance, said Councilman Mark Geis.
That ties in with the biggest issue for most observers and critics, which is access to UPMC Altoona for Highmark health plan subscribers, Cuzzolina said.
SEIU was "right on target" in bringing that issue to council, Schirf said.
Pennsylvania Attorney General Kathleen Kane provided reassurances the day after the merger by saying she will insist that the parties negotiate a deal to ensure such access to UPMC Altoona.
But she didn't speak on one key issue - access to tertiary care at UPMC facilities in Pittsburgh for local patients who need it.
Statements on Friday from both sides, however, might provide reassurance on that point too.
Cuzzolina said in an email:
"If Highmark subscribers are receiving care at UPMC Altoona and need to be transferred to a UPMC tertiary care facility in Pittsburgh for necessary higher level of care, will UPMC still provide the care and accept the Highmark reimbursement? Yes." But there's a caveat.
"The issue will be how Highmark chooses to reimburse subscribers who prefer to go to UPMC or who need to go to UPMC for necessary tertiary care, and to what extent Highmark will try to steer patients away from the preferred UPMC hospitals and doctors and into their own system," Cuzzolina stated.
Highmark's Michael Weinstein had this to say Friday about that:
"Highmark believes a sustainable relationship between Highmark Health Services and UPMC is in the best interests of Blair County residents, assuring that Highmark members will have affordable access to Altoona Regional for years to come and in-network benefits at quality health systems UPMC and Allegheny Health Network [and leading health care providers nationally] if they choose or need to obtain services at advanced care facilities outside of Blair County."
Highmark is ready to negotiate a multiyear agreement to ensure everyone has access to all UPMC facilities and physicians at reasonable cost, Weinstein added.
Thus, it seems that - coupled with the pressure the AG plans to apply - both parties are making statements that more or less commit them to get a deal done that includes tertiary access to Pittsburgh.
Local access became an issue earlier this year when UPMC said it didn't plan to negotiate an overall deal with Highmark after 2014, because Highmark was forming its own healthcare network to rival UPMC's.
UPMC suspects that its celebrated facilities would be just a lure, with Highmark steering patients to its own Allegheny Health Network.
A couple of months ago, UPMC promised to try to negotiate a special contract with Highmark to cover UPMC Altoona because Altoona is a sole community hospital but warned at the time that such a deal would depend on Highmark's being reasonable.
While the lack of a credible alternative hospital here is the basis for the Highmark subscribers' worries, a move by Highmark to buy or build facilities to rival UPMC Altoona would change that calculus.
Might Highmark bring its Allegheny Health Network here?
"It is premature to say specifically if Allegheny Health Network will have a presence in the Altoona region," Weinstein said recently. "[But it] continues to talk with providers across western Pennsylvania to determine if there is a shared mutual interest in working together to improve the delivery of care and to meet specific marketplace needs."
UPMC Altoona will have a presence at the town hall meeting but isn't sure what role it will play, Cuzzolina said.
UPMC Altoona President Jerry Murray would have been the ideal spokesperson, but can't attend, he said.
Still, the hospital will "make sure anyone with questions Tuesday night has a way to ask them and have them answered, if not Tuesday night, then within a few days," Cuzzolina said.
Meanwhile, anyone with questions about the merger can email the hospital at email@example.com or call 889-2271.
Hospital officials "should have nothing to hide," Schirf said.
Mirror Staff Writer William Kibler is at 949-7038.