CLEVELAND — A controversial Cleveland Clinic policy update that left many patients fearing their appointments would be canceled if they didn’t pay upfront is being rolled back, at least in part.
After public criticism and concern from Cleveland City Council, the Clinic has revised its copay policy to include payment plan options and soften what one viewer described as a potentially “dangerous policy.”
The original policy, announced in a message sent on May 13, stated that starting June 1, patients would be required to pay copays at the time of service for non-emergency outpatient care. If they couldn’t, the message said, their appointments could be canceled or pushed back.
Linda Sylor, a Cleveland Clinic patient, said she first saw the update on the news but logged into her MyChart account to verify the change.
“I jumped on MyChart last night and there was the revised policy letter,” Sylor said.
She told News 5 the updated version largely mirrored the original language sent earlier in the month, but with one important difference: a line now confirms that patients will not have appointments canceled or delayed as long as they set up a 0% interest payment plan if they can’t afford their copay at the time of service.
Sylor, who has a Medicare supplement plan, said the original announcement caused confusion and concern because she didn’t know exactly what she would be charged.
She wasn’t alone in her reaction. In an interview with News 5' John Kosich earlier this month, Joel Steven, another Cleveland Clinic patient, said he had concerns.
Thursday, he said he thinks this change is good.
“I am relieved that they backed off from that,” he said. “I think it would be a dangerous policy to turn people away because they didn’t have a copay.”
Cleveland Clinic released a statement Wednesday clarifying the new policy:
“At Cleveland Clinic, our first responsibility is to care for our patients, their health and the well-being of the communities we serve. To bring our mission to those who are in need, we also care for our organization.
Our process update to collecting insurance copays is not intended to disrupt patient care. Commercially insured or Medicare Advantage patients unable to pay their copay can set up a 0% interest payment plan to ensure continuity of care.
Over the past decade, we have observed the growth in out-of-pocket costs for patients through their insurance plans. Copays are a standard part of most plans — a fixed amount determined by insurers, not by healthcare providers, which is to be paid up front before services are provided. In 2024, more than half of copays were not paid when Cleveland Clinic provided services.
We continue to fulfill our obligations to patients who are covered by Medicaid and traditional Medicare. Separate from those plans, we are required to collect copays. Doing so maintains our ability to provide the highest quality care to every patient who needs our services and invest in the communities we serve.”
What’s New
Starting June 1, 2025, Cleveland Clinic will require copays for nonemergency outpatient services at the time of service. If patients are unable to make the copay, they can set up a 0% interest payment plan.
Nonemergency outpatient services include:
- Scheduled office visits (primary care and specialists)
- Therapy services (physical therapy, occupational therapy, speech, etc.)
- Outpatient diagnostic testing (imaging, scheduled labs, etc.)
- Outpatient procedural visits and in-office procedures
This new copay collection process does not apply to patients with Medicaid or traditional Medicare, emergency department visits, urgent/express care visits, surgeries, cancer treatments, or inpatient hospital stays. Copays for these services are still expected but not required at the time care is provided.
Patients who do not have the means to pay for services provided at Cleveland Clinic may request financial assistance. In 2023, Cleveland Clinic helped more than 100,000 patients who could not afford care by providing $261.3 million in financial assistance.
Our Investment in the Community
Cleveland Clinic also pointed to recent investments aimed at improving community health, including:
- $52.5 million to remove lead hazards from Cleveland homes and daycare sites
- $10.4 million to fight childhood hunger and feed vulnerable patients
- $10 million to support the construction of affordable housing
- $2.5 million to expand the Hitchcock Center for Women, helping mothers access safe housing and addiction recovery
“We thank our patients and caregivers for working with us to ensure Cleveland Clinic remains a place of hope, compassion and access for generations to come.”
The backlash didn’t just come from patients. Members of Cleveland City Council were also vocal in their criticism. Cleveland Clinic executives met with the council on May 19 to answer questions and hear concerns.
Councilman Richard Starr told Kosich following that meeting, “This is a direct attack on people in the middle class and lower class.”
He said the council wasn’t informed of the clinic’s intentions before the emails went out to patients.
“But now you just make a decision, make a change, and now you want us as leaders to sit back and say that is it? Well, where's the relationship, where's the collaboration?” he said.
Councilwoman Jasmin Santana, who was also at that meeting, provided a statement to News 5 on Thursday:
“I’m glad to see that the Cleveland Clinic has updated its co-pay policy to better reflect the needs of our community. When they first announced the change, Council President made sure they came before Cleveland City Council to explain their decision and so we could make clear the potential impact on our residents.
After those conversations and, most importantly, after hearing feedback from the community, the Clinic took meaningful steps to revise their approach. As council members, we are committed to improving access to health care especially in a city where health outcomes demand urgent attention.”
Council President Blaine A. Griffin told News 5 Thursday that the original policy could have had a chilling effect on access to care for residents who are already financially vulnerable.
“It was important for us to be able to tell them that people felt that this would have a detrimental effect on the residents of Cleveland, and I’m just glad that they listened,” Griffin said.
He said he had been in communication with Cleveland Clinic for several weeks and expected the policy to shift after raising concerns internally.
“I know these guys. I work closely with them. I do believe they care a lot about the community,” Griffin said. “All I did was really appeal to their hearts and once again, they came through for the community.”
Griffin also released a public statement Thursday, which read in full:
Cleveland City Council President Blaine A. Griffin expressed appreciation following the Cleveland Clinic’s recent decision to revise its policy regarding insurance copayments.
The change comes after Cleveland City Council members raised concerns about the Clinic’s initial policy, which required patients to pay their copays before receiving care. Last week, Council had invited Clinic officials to a caucus meeting to discuss the potential impact of the policy, particularly on residents who may delay or avoid necessary medical care due to financial barriers.
On Wednesday, the Cleveland Clinic announced an update to the policy, stating:
“Our process update to collecting insurance copays is not intended to disrupt patient care. Commercially insured or Medicare Advantage patients unable to pay their copay can set up a 0% interest payment plan to ensure continuity of care.”
Council President Griffin welcomed the revised approach, emphasizing the importance of ensuring that all Clevelanders have access to timely medical services.
“I had honest conversations with the executive team at the Cleveland Clinic about how this policy could hurt people in our community,” said Council President Blaine A. Griffin. “I’m truly grateful they took the time to listen and made changes that help ensure folks can still get the care they need.
“I want to personally thank Vicki Johnson, Chief Community Officer at the Cleveland Clinic, and President and CEO Dr. Tom Mihaljevic for their responsiveness and commitment to the community.”
The revised guidance now states that if a patient cannot pay their copay at the time of service, they will not be turned away as long as a payment plan is arranged. Patients with Medicaid or traditional Medicare are excluded from this policy, as are emergency room visits, urgent/express care, surgeries, cancer treatments, and inpatient stays.
At a statewide gathering of pediatric hospital leaders on Thursday, News 5’s Morgan Trau asked Cleveland Clinic leadership about the decision to revise the policy. Dr. Rita Pappas, Interim Chief of Cleveland Clinic Children's Institute, suggested the situation may have stemmed from confusion.
“In terms of answering your question, I think that some of the things that occur are sometimes misrepresented,” she said. “I can just tell you that I stand by the Cleveland Clinic and every patient’s going to be seen.”
News 5 reached out to Cleveland Clinic for clarity on what exactly may have been misrepresented. A spokesperson responded in a statement:
“Our intent was never to disrupt patient care. We are now offering payment plan options to ensure patients have different options to pay.”
Still, the experience has left some questioning how the initial messaging was communicated and whether it could have been avoided with more careful upfront planning.
“Perhaps some of these questions should have been more carefully considered up front and it wouldn’t have caused this firestorm for the media and for the clinic and for that patience,” Sylor said.
Griffin said Cleveland Clinic’s response is something other corporations should learn from.
“I think it sets an example for what compassionate corporate leadership is,” Griffin said. “I hope all the other hospital systems are watching. Because hospitals should be a right. It should not be something that people have to worry about if they can pay for or not in the best country in the world, in the best city of the world.”
The policy, set to take effect June 1, is part of a broader effort by healthcare systems to manage costs and improve collections. But for many, the balance between financial responsibility and access to care remains a sensitive and closely watched issue.
