UPMC “abused” its nonprofit status to consolidate power over the health care industry in western Pennsylvania, according to a new report from the American Economic Liberties Project. 

The antimonopoly group partnered with Rep. Summer Lee and State Rep. Sara Innamorato to author “​​Critical Condition: How UPMC’s Monopoly Power Harms Workers and Patients,” an 18-page report that equates Pittsburgh to a company town for the health care giant. 

“Like the steel corporations of the last century, UPMC has used its power to depress wages, degrade working conditions, extract money from the public, and, ultimately, create a crisis for the communities in which it operates and in which we live,” Lee and Innamorato said in the report’s introduction. 

UPMC has also faced recent scrutiny from Mayor Ed Gainey, who called for a citywide review of tax-exempt properties in a Jan. 24 executive order, placing the nonprofit’s $1.7 billion in holdings up for review against the state’s standards for a “purely public charity.” The city will also evaluate properties owned by Pitt, Allegheny Health Network and other nonprofits. 

According to the report, UPMC has aggressively purchased and consolidated competing hospitals since the 1980s, a practice that’s associated with slower wage growth for workers and higher mortality rates among patients. Today, it controls 60% of licensed hospital beds in Allegheny County and 71% in Pittsburgh, with much of the remainder belonging to AHN. 

“This report uses many of the same basic data and erroneous statistical analyses that have been reported in the past and thoroughly debunked,” UPMC spokesperson Gloria Kreps said. 

Kreps did not respond to requests for further information on how these statistics have been “debunked.”

The report touts the Innamorato-sponsored Open Markets Act as a state-level measure to prohibit monopolistic behavior and create health care-specific merger review policies. Innamorato introduced the bill in June as part of a Democratic legislative package aimed at fighting inflation. If passed, Pennsylvania would join the majority of states with general antitrust statutes. 

“So many court decisions have removed the teeth from our federal antitrust laws and allowed for this critical concentration of corporate power,” Innamorato said at a virtual press conference for the report. “I’m encouraging Democrats and Republicans to come together on this legislation and put competition back into the health care system.”

The act would also address monopsony power — in this case, UPMC being the overwhelming source of employment for the region’s health care workers. 

The Pitt News spoke with Quincy Schlosser, a patient care technician at a UPMC hospital in Pittsburgh who has seen high turnover and short staffing in his three years on the job. 

Schlosser said employment opportunities shrink dramatically for health care workers who choose to leave UPMC. According to the AELP report, UPMC employs 67% of all hospital workers in Allegheny County, a number that jumps 76% when looking at Pittsburgh alone. 

“You can go to AHN or the VA maybe or you can kick rocks, right?” Schlosser said. 

The report also recommends legislative bans on noncompete agreements and Tuition Assistance Programs, which can force nurses who end their employment to pay back the cost of training. 

Silas Russell, executive vice president of SEIU Healthcare PA, said the report is hardly surprising given longstanding worker complaints about UPMC’s power in the labor market. 

SEIU Healthcare PA bills itself as “Pennsylvania’s largest and fastest growing union of health care workers,” representing UPMC workers at hospitals in McKeesport and Altoona as well as at Western Psych. It also represents some clinical and nonclinical bargaining units in Allegheny Health Network. 

While a third of AHN workers are unionized, UPMC has managed to remain almost entirely nonunion, sometimes by running afoul of federal labor law. The National Labor Relations Board ruled in 2018 that UPMC had illegally threatened pro-union workers and banned organizing materials in the workplace. 

“Any worker who attempts to organize is surveilled, harassed, intimidated and ultimately fired,” the AELP said in the report. 

UPMC did not directly comment on its policy towards unions. 

The region’s dominant health care provider announced plans in January to raise its starting wage to $18 an hour, with Pittsburgh workers set to receive the increase by 2025.

In a press release, UPMC said workers “taking full advantage” of the benefits package, which includes a pension plan, performance awards, health care coverage, paid parental leave and other perks, will earn the equivalent of $27 an hour. 

Schlosser believes that pay raises for nurses are necessary, but still worries about how UPMC’s staffing issues and reliance on travel nurses are reshaping the profession. 

“You’re turning nursing something closer to a gig as opposed to a career,” Schlosser said.