Next week, the University of Pittsburgh Medical Center will open a new hospital in Monroeville, bringing 156 beds and a few hundred new jobs. There's just one thing- less than a mile up the road there's already an established community hospital run by UPMC rival West Penn Allegheny Health System.
On a sunny Saturday morning in mid-June, a couple thousand people toured UPMC's new building. They oohed over the smart glass doors that transform from clear to opaque with a touch of a finger and took pictures of the private rooms. Dorothy Carris, a former ER nurse who retired from Forbes Regional Hospital, said building this hospital so close to Forbes doesn't make any sense.
"It just seems like an unfair battle because UPMC has their own healthcare insurance programs and they have their own hospitals. Now that Highmark is getting into supporting hospitals they are saying that's unfair. The way I see it is it's the exact same equivalency. They're doing the same thing that UPMC is doing."
UPMC East will be less than a mile away from Forbes Regional Hospital, which is part of the West Penn Allegheny Health System. Last year Highmark announced it was buying the system, which many see as a move to become a direct competitor to University of Pittsburgh Medical Center. UPMC has more than twenty hospitals and 400 outpatient clinics and is the region's largest health-care system.
UPMC said it didn't build the $250 million facility to compete. It was built to expand the non-profit's product and to offer people choice.
"Our focus isn't on Forbes at all. It's about spreading out and smoothing the demand for UPMC services across our system," said Mark Sevco, UPMC East's president. He said the goal is to serve the patients who feel it is a hardship to drive into the city and to help relieve the pressure at UPMC Shadyside where, Sevco said, there are frequently not have enough beds for the patient demand.
On any given day, there are 90 people from the eastern suburbs going to UPMC Shadyside for elective treatment like a joint or hip repair. They go because they have UPMC insurance, which they can't use at Forbes Regional, or because they've had other procedures done at UPMC.
"I don't see it as anything negative. You're going to go where your doctor is affiliated. It doesn't really matter," said Donna Wolfson, who lives in Monroeville and is a caregiver for her husband, who had organ transplants at a UPMC facility. "I don't think people have a choice where they want to go. Their insurance dictates where they want to go."
Professionals weigh in
"I would say it is a competition and we will treat it as a competition," said Forbes Regional emergency room doctor Harshad Wadhar, "and we want to be better in the competition, and that's always the goal: to be better, one up over the other."
Forbes gets 50,000 visits to the emergency room department a year. Mark Rubino, the Chief Medical Officer at Forbes, said half of the patients come with commercial insurance, the other half with Medicaid and Medicare. He said the hospital has grown and changed as the community around it has evolved.
"That is what all of the investments have been for the last 10 years with us. I really don't think that's UPMC's intent," Rubino said. "They're not going to have an open heart surgery program. They wont have labor and delivery. They wont have a psych floor… investments we've made to really keep people here. I really don't think that's happening down the street."
The Braddock Question
There's another reason the new facility irks some people. Two years ago, UPMC closed a hospital six miles away in Braddock, which is one of the region's poorest communities. UPMC has said it was closed because it was underutilized and losing money. State records have disputed that claim.
"This hospital being built had nothing to do with that hospital being closed. There's a need in the eastern suburbs, that we think that hospital will serve that," said Sean Logan, VP of Community Relations for UPMC.
Are you being served?
Some in the legislature are worried about the health care industry's decisions when it comes to capital investments, such as new hospitals. State Senator Jim Ferlo (D-Pittsburgh) has proposed a law that would provide public oversight of such investments. Ferlo said in a few years, there will very likely be two battling healthcare empires, both bringing in billions in revenue and enjoying non-profit status. He said there needs to be checks and balances in the system.
Monroeville's Mayor Greg Erosenko said while the town was split when the decision was made to put an additional hospital in the community, he welcomed it. "Walk in the mayor's shoes," Erosenko said. "Any time I can get jobs in my area, I'm certainly going to do anything I can do within the power of municipal government to enhance that."
The mayor sees Mosside Boulevard turning into a mini-medical corridor. There's talk of for-profit physician offices moving closer to the hospitals.
Highmark's purchase of the five-hospital West Penn Allegheny System is still waiting approval. But it appears they're feeling confident about their expansion into this area - Highmark just announced 75 million in investments to another smaller local health care system- Jefferson Regional Medical Center.
This story was produced in collaboration with NPR and Kaiser Health News.