As Obamacare struggles, MetroHealth offers an alternative
MetroHealth Medical Center
(Angela Townsend )
CLEVELAND, Ohio -- As stewards of a hospital that serves a large Medicaid population, executives with MetroHealth have supported the Affordable Care Act, which expanded insurance coverage to hundreds of thousands of low-income Ohioans.
But that doesn't mean they don't see flaws in the landmark law.
On Wednesday, the health system rolled out a program aimed in part at catering to people unhappy with the cost and complexities of their Obamacare plans. The program, called Select Direct, will allow patients to get primary care services by paying a fixed monthly fee.
Members would not have to bother with copays or deductibles, or an incomprehensible explanation of their benefits.
"You pay the amount and we'll take care of all of your preventive and health maintenance needs," Dr. Akram Boutros, MetroHealth's chief executive, said. "For less than $50 a month, you can buy all the services you need."
MetroHealth unveiled the program as it prepares for its annual stakeholders meeting in Cleveland today. The event offers a snapshot of the health system's financial performance and strategy for the future.
Boutros said Wednesday that the Select Direct program could serve as an alternative to Obamacare, noting that the cost of coverage is bound to rise as insurers confront losses on their ACA plans. He even went so far as to forecast the collapse of the federally facilitated exchange that supports the law. Ohio's Obamacare cooperative, InHealth Mutual, announced plans to close last month.
"My view is that, after Obama, the exchange is going to collapse," Boutros said. "I don't think there's going to be political support to continue at those rates. Those rates are going to go up, so there's got to be another option."
Enter MetroHealth's new program, Select Direct.
The health system said it will offer three tiers of membership -- preferred for $40, premium for $65, and platinum for $80. Those rates are approximate and would be adjusted based on a member's age, clinical needs and other factors, MetroHealth said. Each tier will cover doctor visits and a variety of other services, such as screenings and immunizations.
Members will have access to more than 200 MetroHealth primary care physicians at more than 20 locations. Boutros said the program could serve as a supplement to high-deductible insurance, or as a new option for people who don't have insurance.
In an interview Wednesday, he also said that while Obamacare has expanded insurance coverage in Ohio, the law has not resulted in a financial windfall for MetroHealth. That's because the increase in revenue from patients has been offset by cuts in federal aid meant to help hospitals with high amounts of uncompensated care.
"For us, this has not been a positive," he said. Boutros quickly noted, however, that he still sees Obamacare as a success.
"We're providing services earlier on to people," Boutros said. "Even if doesn't make more money, it fulfills our mission. And we're happy about that."