AKRON, Ohio — Starting Sept. 1, non-emergency patients with out-of-network insurance plans will no longer be accepted at Summa Health System.
The new policy, announced on its website, includes walk-in services at Summa Health Urgent Care Centers and laboratory and radiology services. The change will not apply to emergency services, which are required by the Emergency Medical Treatment & Labor Act (EMTALA).
There will be limited exceptions to the policy for services where Summa Health is the only provider in the region.
Some patients told News 5 they’re nervous about the policy’s implications.
“It could definitely cost a lot of people healthcare that they need and deserve,” said Jared Somerick.
He and his father, John Somerick, were at Summa Health’s main Akron campus after his mother’s most recent surgery following a brain aneurysm.
“She’s getting discharged today so we’re taking her home,” he said.
The family explained it’s been a difficult journey and it was even more stressful in late 2024 when their insurance provider, Anthem, and Summa Health were renegotiating a contract. Care providers informed the family they could be responsible for all medical bills if a deal was not reached.
“It was a lot of money, $100,000 just for a deposit,” said John Somerick.
He said he empathizes with patients who are out-of-network and will have to find new health providers starting next month.
“There’s no question, it’s totally financial,” said JB Silvers, a professor of healthcare finance at the CWRU Weatherhead School of Management.
He explained hospital systems are rarely able to fully collect the money owed by uninsured patients or out-of-network insurance plans.
“This policy is in place not only to protect Summa Health but also the patient,” Summa Health spokesperson Maureen Nagg told News 5 in a statement.
She said the health system uses “significant resources” seeking payment from a patient’s insurance provider.
“Often that effort results in little, to no, payment. The patient is then responsible for any remaining bill, which can be substantial,” said Nagg.
Silvers said Summa’s policy change is not surprising. He anticipates other healthcare systems to implement similar measures following the passage of the congressional spending bill.
Analysis from the Congressional Budget Office suggests up to 16 million Americans could lose insurance coverage because of Medicaid cuts and changes to the American Care Act (ACA) marketplace.
“The concern I think everybody has now is it’s going to get worse,” said Silvers. “With medicaid cutbacks, there’s just no question. And with eligibility and the cost of care, with the affordable care plans, with Obamacare going up dramatically, hospitals are basically scared. And for good reason.”
For its part, Summa Health said the policy change was not prompted by federal cuts or a pending sale of the health system. The Ohio Attorney General approved the nonprofit’s acquisition by private equity firm HATCo in June.
RELATED: Non-profit Summa Health to be acquired by health care venture capital firm
“Summa Health enjoys strong working relationships with more than 25 contracted health plans throughout the region,” Nagg said in a statement. “As a result, similar to other healthcare organizations, we are often engaged in collaborative dialogue around new and existing contracts.”
Some patients praised the care they’ve received at Summa Health and told News 5 finding new healthcare providers would be a burden.
“I love this hospital, but I’d have to go wherever my insurance would pay for it,” said John Somerick.
