Premier Medical Associates expands despite Highmark-WPAHS tiff

Highmark’s skirmishes with the West Penn Allegheny Health System have not affected rapid growth of the insurer’s biggest physician practice.

Monroeville-based Premier Medical Associates on Oct. 1 hired orthopedist Dr. Charley Gates, the latest in a rapidly expanding array of specialists Premier has picked up.

Premier had 65 medical providers when the practice affiliated with Highmark in late 2011. Now, it is expected to expand to more than 100 by the first quarter of 2013, according to CEO Mark DeRubeis.

At the same time, Premier has been hiring nurse practitioners and physician assistants, so-called physician extenders who allow doctors to focus on managing chronic medical conditions such as diabetes and congestive heart failure. Physician extenders are expected to number 15 by the end of the first quarter of 2013, triple the number from 2011.

“Extenders are critical to meet acute medical needs that arise,” DeRubeis said. “What is critical is that the labor is divided appropriately. The extenders become a very important part of the care team.”

Extenders are assuming a bigger role in health care elsewhere as curbing health care costs and addressing the shortage of primary care physicians have become pressing needs.

In 2008, there were 74,800 physician assistants nationwide, which was projected to reach 103,900 by 2018, according to the Bureau of Labor Statistics. The median salary was $90,000, the American Academy of Physician Assistants found, which is much lower than a physician’s salary.

Highmark took a controlling stake in Premier as part of its plans to create an integrated health care delivery system to compete with the bigger and better financed University of Pittsburgh Medical Center.

Terms were not disclosed, but Premier’s doctors are key to WPAHS, said spokeswoman Kelly Sorice.

“They’re extremely important in the East,” she said. “They’re respected by physicians, the community and patients.”

Since then, Highmark petitioned the state Department of Insurance to acquire WPAHS for $475 million. But WPAHS on Sept. 28 said Highmark breached the acquisition agreement, and the hospital network would immediately begin shopping for another partner.

Highmark has since sought an injunction to prevent WPAHS from talking with any other partner.

But Premier’s growth has been unfazed.

During the past year, Premier has picked up specialists in gastroenterology, psychiatry and orthopedics. And by the first quarter of 2013, the practice anticipates having specialists in dermatology; ear, nose and throat; and ophthalmology, DeRubeis said.

Premier is quickly outgrowing its Monroeville headquarters as a result of the growth. Renovations are planned or completed at all of Premier’s offices, and the practice is preparing to close on a property in Penn Hills that will house billing operations.

Last year, Premier purchased a 2.5-story building on Route 30 in Forest Hills to relieve some of the congestion in Monroeville while continuing to scout new properties.

“We’ve filled out our footprint, and we’re looking for additional locations,” DeRubeis said.

Premier was among the early pioneers of the patient-centered medical home in the region, where patients receive coordinated, comprehensive care.

In Premier’s care model, doctors focus on managing chronic health problems, while extenders take care of acute medical problems such as the flu and colds.