Shifting population patterns and other factors are continuing to transform the healthcare landscape in Ohio. Some health systems are expanding by constructing new hospitals. Other health systems are facing regulatory challenges from insurance providers and other health systems.
As an overall piece of Ohio’s economy, healthcare is an important part of the state’s overall GDP. Some of top hospitals in the nation are located in the state. In this environment, some health systems are facing significant financial headwinds while other hospitals have grown in size.
Rival Hospitals and Insurance Contracts:
In Ohio, the U.S. Court of Appeals for the Sixth Circuit reversed an earlier legal injunction. Initially, it was decided that Paramount insurance had to continue their relationship with McLaren St. Luke hospital which is located in Maumee, Ohio.
Formerly known as St. Luke’s Hospital, in 2020 this hospital was purchased by McLaren Health Care which is based out of Michigan. Paramount is an insurance subsidiary of ProMedica Health System and is based out of Toledo and has locations throughout northwest Ohio and southeast Michigan.
The federal court supported ProMedica’s move, through Paramount, to end their in-network insurance relationship with McLaren St. Luke Hospital. The original push to end this relationship was halted by an earlier preliminary injunction out of anti-trust concerns. This court order had required Paramount to continue to provide in-network coverage for medical practitioners connected to McLaren St. Luke Hospital.
The earlier court decision had prevented ProMedica from terminating existing insurance contracts with St. Luke’s Hospital. The more recent court ruling stated that the act of selling the hospital to another healthcare company, grants ProMedica the option to re-examine their contractual insurance relationships. The judge argued that it is now ProMedica’s right to alter or end contractual insurance relationships with the newly purchased hospital which is now owned by a competitor.
New Inpatient Hospitals:
In central Ohio, both OSU Wexner Medical Center and OhioHealth are opening new hospitals and expanding services.
The OSU Wexner Medical Center is building a new hospital next to their current center’s location in Columbus, OH. The new hospital is scheduled to open in 2026. The inpatient facility is estimated to have 820 hospital beds in private rooms. The building of the new hospital is listed as the largest single facility construction project ever undertaken at Ohio State University.
A similar expansion/upgrade of medical facilities is occurring at OhioHealth. In the New Albany area of central Ohio, the health system is converting existing construction. The new medical site will be known as the New Albany Medical Campus and will deliver comprehensive outpatient services.
Interestingly, OSU Wexner Medical Center is also building new outpatient care facilities in the New Albany area.
OhioHealth is also building a new hospital in another part of central Ohio. In the town of Pickerington, the health system will expand its existing Pickerington Medical Campus. The new facility will include inpatient beds as well as provide new services.
The planned name for the new healthcare facility is OhioHealth Pickerington Methodist Hospital.
Trends: Health Systems & Ohio:
The Columbus metro region, which includes seven counties, is one of the fastest growing regions in the Midwest. As the population of central Ohio continues to grow, the region’s various health systems will likely benefit and also grow.
At the same time, new entities are starting to offer healthcare services. Companies like Walmart and Google are increasing their role in the U.S. healthcare system. Now whether these new medical providers will impact large and established central Ohio health systems like OSU Wexner or OhioHealth remains to be seen.
To date, companies like Walmart, Apple and Google have focused on outpatient treatments and similar healthcare supportive services and technologies. What is for sure is that future mergers and population trends will continue to impact insurance providers and health systems in the state.
About Us:
As an Ohio-based company, Advanced Billing & Consulting Services (ABCS) provides solutions for healthcare professionals. Medical billing, Ohio waiver provider agencies services, credentialing as well as online advertising.
For questions email or call us at 614-890-9822.
Follow ABCS RCM on Facebook, Instagram and Twitter:
#TelehealthBilling #TelepsychiatryBilling #MedBilling #IOPbilling #mentalhealthbilling #medicalbillinghelp #healthcaretrends #PHPbilling #Behavioralhealthbilling #Ohiopracticemanagement #OhioMed #CredentialingHelp #CredentialingHelp #HCBSwaiverproviders #eWebSchedule #Medicaidwaiver #Timecards #EVVOhio