Cleveland-based MetroHealth plans to launch an initiative to help patients enroll in Medicare, Medicaid and ACA’s marketplace insurance to reduce its soaring charity care costs that now exceed $1 million per day, a spokesperson for the health system confirmed to Becker’s.
That figure puts MetroHealth — Cuyahoga County’s safety-net hospital system — on track to spend more than $350 million on charity care in 2025. That is hundreds of millions more than what it receives from the county’s health and human services levy, according to Signal Cleveland.
“MetroHealth is experiencing an unprecedented and unexpected surge in the cost of care it delivers to Greater Cleveland’s uninsured,” the system said in a statement to Becker’s. “Our charity care costs have doubled since 2022 and now exceed $1 million a day. With input from several community stakeholders, we are working to identify strategies to reduce this burden without compromising our role as Cuyahoga County’s safety-net hospital.”
As part of the effort, uninsured patients may soon be required to meet with MetroHealth’s financial counseling team to review coverage options before qualifying for charity care, Signal Cleveland reported. The proposal would also tighten eligibility requirements.
Currently, Cuyahoga County residents earning up to 300% of the federal poverty level — about $96,000 for a family of four — can qualify for free care. MetroHealth may lower that threshold to 250%, bringing it in line with policies at other local systems, including Cleveland Clinic and University Hospitals, according to the report. Patients above that income level would still receive discounts, though some would be smaller than under the current policy.
“One of the major pieces is participating in a community-wide collaboration to encourage people who qualify to enroll in Medicare, Medicaid and insurance through the Health Insurance Marketplace,” a MetroHealth spokesperson told Becker’s. “We will share more details as those plans are finalized.”
Expanding insurance enrollment will be key to creating “a more equitable sharing of costs so that the federal general financial aid program can focus on those with the biggest and deepest needs,” Board Chair E. Harry Walker, MD, said at an August board meeting, according to cleveland.com.
The insurance enrollment initiative is the latest in a string of stabilization efforts at MetroHealth.
In July, the health system laid off 125 employees, mostly in administrative roles, and froze some nonclinical hiring. The system is also closing six outpatient facilities in October, consolidating services to larger locations. It also plans to open a new outpatient health center with a 24/7 pharmacy in 2026.
“Any organization, especially one facing financial challenges, must constantly look at ways to operate more efficiently,” MetroHealth President and CEO Christine Alexander, MD, said in a statement. “This move is a continuation of our efforts to right-size our footprint by aligning our resources with our priorities.”
Despite mounting pressures, MetroHealth said it will continue to provide care to all patients regardless of ability to pay, but stressed that its current trajectory is not sustainable.
Becker’s has reached out to MetroHealth and will update this story as more information becomes available.
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