Medical Mutual and University Hospitals Score Competitive Victory for Cleveland: Editorial

At a time of uncertainty and turmoil in health insurance markets, today’s announcement that – for the first time in more than two decades – all facilities and suppliers to teaching hospitals will be part of of the SuperMed and Medicare Advantage networks of Medical Mutual of Ohio is a huge win for consumers, for Cleveland and for the state.

The move, jointly announced by Medical Mutual and UH this morning, and which will take effect Oct. 1, expands both the competitive reach and healthcare impact of two of Cleveland’s largest employers.

But above all, it is a breakthrough for patients.

The decision ensures continuity of care for those already part of the medical mutual’s SuperMed and Medicare Advantage networks who have UH physicians but previously could not access services at UH hospital facilities at its main campus in Cleveland. These include Seidman Cancer Center, MacDonald Women’s Hospital, and Rainbow Babies and Children’s Hospital. The decision also brings UH’s Bedford Medical Center into both networks.

Procedures at all UH facilities, including specialty treatments for cystic fibrosis, proton therapy cancer treatments, and childhood cancer care, will now be covered for health plan members “at their levels. highest benefits,” according to the joint press release.

For UH, the agreement fills an important gap by ensuring that UH is part of all major health insurance plans in the region.

In the past, employers had to choose between an exclusive agreement with Medical Mutual that would prevent employees from seeing UH doctors in main campus offices and prohibit access to important procedures at those facilities, or an agreement with several insurers. Now, an exclusive agreement with Medical Mutual covers all hospital campuses in Cleveland.

Given the uncertain future of medical insurance and unclear prognoses for Obamacare’s health insurance provisions that have caused at least two major health insurers to pull out of the Obamacare Ohio market in recent months, an agreement that makes health insurance healthier and stronger is a good prescription for everyone.

And UH no longer loses access to the Cleveland-based insurer’s clients.

“This is a great day for our members,” said Rick Chiricosta, President and CEO of Medical Mutual, in a joint statement. UH CEO Thomas F. Zenty III called it a “momentous deal.”

They’re right. Amid the clouded outlook for health care in America, this is a complete victory for local providers, patients and a health and hospital insurance system that employs thousands of people in the city of Cleveland.

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