Move could force thousands of patients to choose a new health care provider or face higher “out-of-network” costs
ProMedica’s Paramount health plan has notified McLaren St. Luke’s of its plans to terminate the hospital’s in-network provider status, effective January 1, 2021. The move would effectively prohibit thousands of northwest Ohio residents covered by Paramount health plans from receiving care from McLaren St. Luke’s or its affiliated physician practice, WellCare Physicians Group, by subjecting them to higher, out-of-pocket costs.
As a result of ProMedica’s decision, many patients who have come to depend on McLaren St. Luke’s will be forced to go elsewhere to receive care and may no longer have in-network access to their physicians and other trusted health care professionals. The termination is estimated to impact thousands of northwest Ohio employees, family members and retirees who are currently enrolled in Paramount’s medical benefits plan through their employer or through Paramount Medicare Elite.
“We are surprised and disappointed by ProMedica’s decision, which significantly reduces access to care for their health plan members who live and work in Maumee and the surrounding communities,” said Jennifer Montgomery, RN, MSA, FACHE, president and CEO of McLaren St. Luke’s. “This is especially unfortunate given all that McLaren St. Luke’s has overcome and our commitment to preserving jobs, investing in new facilities and technology, and expanding health care services to provide a broader range of care in the community.”
The termination comes just days after McLaren Health Care completed the acquisition and subsequent rebranding of St. Luke’s Hospital, which has struggled financially since the FTC ordered the divestiture of St. Luke’s Hospital from ProMedica in 2016. McLaren has committed to investing more than $100 million to modernize the facility and support new and expanded technology and services including trauma care, enhanced cardiology services and an updated intensive care unit. The notice of termination stated that it was issued because of McLaren’s acquisition of St. Luke’s, which is expected to provide these important benefits, as well as greater competition for ProMedica.
“This is an important time for our hospital and patients, which will suffer very significantly as a result of ProMedica’s decision. We will continue to explore all of our legal options to ensure patients can continue to receive care from the providers they know and trust,” said Montgomery. “However, with open enrollment around the corner, we are urging community members and area employers to carefully review their benefit options and select a plan that includes McLaren St. Luke’s as part of its network.”
McLaren St. Luke’s will continue to update the community on this important development. In the meantime, Paramount members are urged to contact the health insurance company with any questions or concerns.