ProMedica and Medical Mutual have officially finalized a multi-year network agreement. This deal ensures that thousands of patients will maintain in-network access to ProMedica facilities and services. The agreement avoids a disruption that would have forced many to pay higher out-of-network fees starting in 2026.
The resolution comes after a contract dispute that began in August 2025. Without this new agreement, patients insured by Medical Mutual and its subsidiary, Paramount, would have lost their in-network coverage at various ProMedica hospitals and medical offices across the region.
Key Takeaways
- ProMedica and Medical Mutual secured a multi-year network agreement.
- Thousands of patients will keep in-network access to ProMedica facilities.
- The deal prevents higher out-of-network costs for Medical Mutual and Paramount members.
- The agreement covers various insurance products, including employer-sponsored and Medicare Advantage plans.
Ensuring Continued Patient Care
The new agreement means patients covered by Medical Mutual and Medical Mutual-Paramount plans can continue receiving care without facing significant price increases. This applies to a wide range of insurance products. These include employer-sponsored health plans, commercial insurance, Affordable Care Act (ACA) health insurance marketplace plans, and Medicare Advantage plans.
The potential loss of in-network coverage was a major concern for many families. It would have impacted access to critical facilities. These facilities include ProMedica Toledo Hospital, Toledo Children's Hospital, ProMedica Flower Hospital, and ProMedica Bay Park Hospital. Numerous urgent care centers and medical offices owned by ProMedica in the area were also at risk.
Important Fact
The finalized agreement prevents an estimated tens of thousands of patients from transitioning to out-of-network status, which would have increased their healthcare costs significantly.
Leadership Expresses Satisfaction
Leaders from both organizations expressed relief and satisfaction with the outcome. Dr. Kent Bishop, Chief Medical Officer at ProMedica, highlighted the importance of the patient-provider relationship.
"The relationship between patients and providers is vital to a person's health and overall well-being. We are pleased to have come to a fair and equitable agreement with Medical Mutual that respects and upholds this essential connection."
This statement underscores the commitment to patient well-being that both parties emphasized throughout the negotiations. The successful resolution prevents a disruption that could have negatively affected patient continuity of care and financial stability.
Impact on Insurance Products
The comprehensive nature of the agreement is significant. It covers all products offered by Medical Mutual and its subsidiary, Paramount. This broad scope ensures that a diverse group of patients, from those with employer-sponsored plans to seniors on Medicare Advantage, will retain their current access.
For individuals with employer-sponsored coverage, any questions about their specific plans should be directed to their employer's Human Resources department. Other Medical Mutual commercial and Medicare Advantage members can contact Medical Mutual directly for assistance.
Background on the Dispute
The contract dispute originated in August 2025. It raised concerns about the future of healthcare access for many local residents. The primary issue revolved around the terms of the network agreement, which determines how much insurers pay providers for services. Without a new deal by early 2026, the existing contract would have expired, leading to out-of-network charges.
Looking Ahead
The multi-year nature of the finalized agreement provides stability for patients and providers alike. It removes uncertainty about healthcare access and costs for the foreseeable future. This stability allows ProMedica to continue its mission of providing comprehensive medical services to the community, while Medical Mutual members can confidently plan their healthcare needs.
The successful negotiation serves as an example of how healthcare providers and insurance companies can work together to prioritize patient access and affordability. It ensures that the essential connection between patients and their doctors remains strong and uninterrupted.
