Hospital system no longer accepting radiology patients with out-of-network health plans
An Ohio hospital system announced this week it will no longer accept radiology patients with out-of-network or noncontracted health plans.
Akron-based Summa Health said the change will take effect Monday, Sept. 1, with the two-hospital acute care network ceasing scheduling of appointments for this consumer segment. The move includes walk-in services at Summa Health Urgent Care Centers, along with radiology and lab offerings, and its medical group. However, the system said the change does not apply to labor and delivery and other emergency care.
The move comes as insurers and radiology providers wage wars over contract negotiations, with some payers pushing imaging groups out of network when unable to reach a deal.
“When patients receive care that is out of network or noncontracted with their insurance provider, the health system spends significant resources trying to obtain any payment from the patient’s insurance provider,” Summa Health said in a statement shared with local media. “Often that effort results in little to no payment. The patient is then responsible for any remaining bill, which can be substantial.”
The hospital system shared a list of over 40 health plans with which it contracts. Akron Radiology Inc. and its 30 physicians currently are the exclusive provider of subspecialized radiology interpretation and interventional procedures. This includes Summa Health’s two hospitals, 10 outpatient health centers, five emergency rooms and four urgent care centers, according to the private practice.
Summa Health also is finalizing its transition to a for-profit hospital system following a $485 million sale to venture capital firm General Catalyst, the Cleveland Plain Dealer reported. First announced last year and approved by the state attorney general in June, the move will make Summa the only private equity-owned major hospital in northeast Ohio. Currently, about 488 U.S. hospitals are owned by PE firms, representing about 8.5% of all private hospitals, according to the Private Equity Stakeholder Project.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.