Highmark acquires Triangle Urology

Highmark Inc. on Monday acquired Triangle Urological Group, the biggest independent medical practice of its kind in western Pennsylvania and the second-biggest physicians’ group picked up by the health insurer in its drive to build a new health care delivery system.

Highmark spokesman Aaron Billger announced the deal Tuesday. Triangle was founded in 1926 and has six offices, seven doctors, and nine physician assistants and advanced degree nurses.

"Our integrated delivery network objective is centered around creating a vibrant network of independent community hospitals; an aligned network of physicians, both primary care and specialists; broader choice in health care services; and more convenient access to innovative ambulatory services," Billger said in a prepared statement.

Triangle has been based at Allegheny General Hospital for years and the acquisition followed a year of negotiations during which Triangle also was courted by the University of Pittsburgh Medical Center. One factor that tipped Triangle to Highmark was granting Triangle doctors greater control over ancillary care provided to patients, including such things as home care, according to a person familiar with the terms of the deal, but who was not authorized to speak publicly about it.

In controlling all aspects of the patient’s care, Triangle’s goal is to maximize the quality of care provided while holding down costs, this person said. Triangle’s preferred approach dovetails with new reimbursement models that Medicare has been rolling out, including capitation or bundled payments for a group of services.

Another feature of the agreement: Triangle doctors are not compelled to drive patients to Allegheny General Hospital for treatment, according to this person. Doctors are free to continue doing procedures at UPMC Passavant Hospital, for example.

Siphoning patients from outlying hospitals to city academic medical centers has been an issue for providers including Excela Health, which feared the loss of patients who could be treated near their homes and at a lower cost than in the city. Highmark officials have said the West Penn Allegheny Health System needs to increase patient volume by at least 20,000 patients to reach financial viability.

In January 2012, Highmark acquired a controlling interest in Monroeville-based Premier Medical Associates, then the biggest independent physicians practice in the region. Premier has 61 doctors at 10 offices, offering a wide range of primary and specialty care.

Separately, three WPAHS primary care doctors are moving to UPMC in July, WPAHS spokesman Dan Laurent said Tuesday.

Drs.X. Helen Wang, Heather Hanzlik and Dominick DeFrances have quit the Allegheny Valley Internal Medicine practice in Lower Burrell, leaving behind Drs.Vincent Vargas and Nithya Guhanand.

The change surprised 75-year-old Saxonburg resident Fred Honzo, who had trouble reaching DeFrances, his doctor for nine years.

"He just up and left," said Honzo, who was supposed to see DeFrances on March 29. "I'm up a tree.

"Now, I have no doctor."