La Mutuelle Médicale integrates all university hospitals into its SuperMed network

“If there’s one thing that’s probably just as important and maybe more important, it’s cost and so the challenge has always been how do you achieve that, how do you improve access and make sure the cost of health care is kept at the same level or lower,” he said. “And we’ve finally found a way to do that, and that’s the part that I’m so happy and proud of.”

As a result of the agreement, UH now participates in all major health insurance plans in Northeast Ohio, and the Medical Mutual SuperMed network now has all major health systems in the region represented, according to the release. Medical Mutual members will be able to access all UH facilities with the highest level of benefits.

“The reason this was so important is that the beneficiaries of this agreement are really the thousands of patients who have come to us over the years and who, in many cases, have paid higher deductibles for being able to access our healthcare system,” said Thomas, CEO of UH. F.Zenty III.

Bedford and all major campus facilities constituted the entire UH system at the time of the contract decision in the 1990s. Other medical centers that have been added since then, such as Ahuja, Parma, and Geauga, have been incorporated to the network as they come online.

But members of Medical Mutual who wanted to receive care on the main campus, which contains much of UH’s specialty programs and technology, would have to pay out-of-network costs.

“It bothers me that we had a major employer and a major supplier who were kind of left out of our network,” he said. “It wasn’t the easiest thing in the world to do, but because of all of that, it was just important for us to do it and we did it. So we improved access for all of our members, and we’ve done it without increasing the cost. And those two things had to happen or it wasn’t going to work.

Chiricosta was also quick to note that Medical Mutual has maintained its strong partnership with the Cleveland Clinic.

Medicare members already have access to UH doctors and other facilities in the UH system, but Chiricosta noted that some people still believe that all UH services are excluded from the MMO network. .

Members can now access all of UH’s services, such as proton therapy, its cystic fibrosis program, and the Angie Fowler Adolescent & Young Adult Cancer Institute.

Of Medical Mutual’s 1.5 million members, about 650,000 live in northeast Ohio.

The expanded access, according to Zenty, will bring more patients to UH, where primary care physicians and other system physicians are treating “tremendous numbers” of Medical Mutual patients. But when these patients needed a higher level of care, they either had to go through a difficult approval process, pay higher deductibles, or seek services elsewhere.

The setup also left Medical Mutual at a competitive disadvantage, Chiricosta said, because the companies said they didn’t want a product that excluded teaching hospitals. Employers decided either not to do business with MMO at all, or to add a second option to provide access to UH.

“In both cases, it has hurt us over the years,” he said. “We did quite well despite this competitive disadvantage. I’m excited to think about how we could move forward by eliminating this competitive disadvantage.”

“La Mutuelle Médicale brings together all the facilities of University Hospitals in its SuperMed network”initiallyappearedinCrain’s company in Cleveland.