CLEVELAND, Ohio – For the first time in more than 20 years, Medical Mutual of Ohio’s SuperMed network – and its 1.5 million members – will have access to the entire teaching hospital system.
Starting October 1, the hospital system’s main campus and UH Bedford Medical Center will become part of Medical Mutual’s SuperMed Network and Medicare Advantage Network. The companies jointly announced their agreement on Thursday morning.
For decades, Northeast Ohio’s 650,000 SuperMed members have had access to community hospitals and UH doctors. But they couldn’t use major campus hospitals or Bedford facilities without risking off-grid charges, due to an exclusionary contract Medical Mutual had with the Cleveland Clinic. This contract provided for a sharp increase in costs for Medical Mutual if the insurer added UH to the SuperMed network.
But that contract expired years ago. And in an uncertain healthcare environment, insurers and hospitals are making changes to ensure sustainability.
“I wasn’t sure this would become a reality,” said Rick Chiricosta, CEO of Medical Mutual. “If it hadn’t been for the crazy environment in health care, I don’t think it would have been possible.”
The deal will not increase members’ costs, Chiricosta said.
Under the new contract with UH, SuperMed members will benefit from more continuous cooperative care across the healthcare system than they do today, said Tom Zenty, general manager of the hospital system. Patients treated by UH primary care physicians or UH community hospitals will be able to access UH Cleveland Medical Center at University Circle if their condition requires it, without fear of high bills for off-grid services.
“From my perspective, this had been, in the past, a pretty big break in the continuity of care that patients would receive,” Zenty said. “Now all of these barriers have been removed throughout our health care system.”
The expansion will give patients access to the UH Proton Therapy Program, the Childhood and Adolescent Cancer Program, and the Cystic Fibrosis Program, among other services.
With this agreement, UH is now part of all major health insurance plans covering the region. And Medical Mutual’s SuperMed network now includes all of the region’s major health systems.
Both companies said they expected an increase in customer numbers – and a better competitive advantage – as a result of the deal.
Employers and patients covered by Medical Mutual might be more likely to choose teaching hospitals after September because they won’t have to face such high fees to visit the hospital’s main campus, Zenty said. And Medical Mutual believes employers might be more inclined to choose the SuperMed network, knowing that employees with UH doctors will have full access, Chiricosta said.
The SuperMed network includes 24,000 primary care physicians and 60,000 specialist physicians at over 200,000 sites across the state.