Sunday, Apr 22, 2018
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ProMedica inks contract with Medical Mutual

The Toledo region's largest health-care system yesterday announced that it too signed a contract with one of northwest Ohio's biggest health-insurance providers, one day after Mercy Health Partners unveiled a similar contract.

ProMedica Health System signed a contract with Medical Mutual of Ohio, which will allow the insurance company's more than 200,000 customers more choice over their health care providers, said Randy Oostra, president and chief operating officer at ProMedica.

Beginning Jan. 1, customers will have access to both ProMedica hospitals and Mercy Health system facilities, Mr. Oostra said.

The new contract Medical Mutual signed with Mercy Health Partners removed disincentives that kept the company from a full contract with the ProMedica Health System, which operates Toledo Hospital and eight others.

ProMedica has not been a member of Medical Mutual since 1989.

"From a member's perspective, there's a lot more access, a lot more choice," Mr. Oostra said.

ProMedica is now the area's only health-care system that has contracts with three of the largest insurance plans in northwest Ohio, including Paramount Health Care, which is owned by ProMedica; Anthem Blue Cross/Blue Shield, and Medical Mutual.

The increased access the contract provides is important to both patients and physicians, said Kevin Lauterjung, vice president of network management at Medical Mutual.

Prior to the contract, doctors would often steer Medical Mutual members to Mercy Health facilities because they were a part of their network.

"It means [customers] ultimately have more choices," Mr. Lauterjung said.

Patients were able to visit any hospital they chose, but they paid higher out-of-pocket costs if the facility was not part of Medical Mutual's network of hospitals, he said.

Patients now will receive the highest benefit-level of coverage at both Mercy and ProMedica hospitals, Mr. Lauterjung said.

"With this move of adding ProMedica back to our network, it may be the start of a new cycle," Mr. Lauterjung said. "It clearly will open up new opportunities for our customers."

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