Changes to SUMMA Health System’s Insurance Policy
AKRON, Ohio – Beginning September 1, SUMMA Health System will no longer accept non-emergency patients with out-of-network insurance plans. This new rule, which affects walk-in services at Summa Health Urgent Care Centers, as well as Laboratory and Radiology Services, won’t apply to emergency services mandated by the Emergency Medical Treatment and Labor Act (EMTALA).
There are some exceptions, particularly for services where Summa is the sole provider in the area. A few patients have expressed concerns about how this could affect them. Jared Somerck mentioned, “It can cost a lot of people that deserve what they need.” He and his father, John Samerick, were at the main Akron campus to take his mother home after her surgery for a cerebral aneurysm.
“She was discharged today, so we’re taking her home,” he shared. The family noted that the entire experience has been challenging, especially during negotiations in late 2024 between insurance providers Anthem and Summa Health, where care teams warned families about potential financial liabilities.
John Samerik recalled, “It was $100,000 just for a lot of money, a deposit.” He expressed that the need for a new healthcare provider would become necessary next month, highlighting the financial implications for many.
JB Silvers, a healthcare finance professor at CWRU Weatherhead School of Management, noted, “There’s no doubt about it. It’s completely financial.” He elaborated that hospital systems typically struggle to collect payments from uninsured patients and those with out-of-network plans.
According to Summa Health spokeswoman Maureen Nagg, this policy aims to safeguard both the health system and its patients. “Our health system utilizes critical resources that require compensation from insurance providers.” She added that often these efforts result in no payment, leaving patients responsible for the remaining costs.
Silvers wasn’t surprised by Summa’s move, predicting that other healthcare systems might adopt similar policies following the Congressional Expenditure Bill discussions. An analysis by the Congressional Budget Office estimated that potential Medicaid cuts and modifications to the Affordable Care Act (ACA) could see around 16 million Americans losing their insurance coverage.
“There’s a growing concern that it might worsen,” Silvers commented. “If Medicaid faces cuts, it will certainly impact hospitals, especially with the rising costs associated with Obamacare.” Summa clarified that the recent policy changes weren’t driven by federal funding cuts or the acquisition of healthcare systems, as the Ohio State Attorney General approved the transition of the nonprofit to private equity firm Hatco in June.
Nagg emphasized, “Summa Health has a robust collaboration with over 25 contracted health plans across the region,” suggesting that they frequently engage in discussions about contracts with healthcare organizations.
Some patients have reflected positively on the care they received at Summa Health and are apprehensive about finding new providers. “I love this hospital, but I have to go where insurance pays,” said John Somalick.
