The Cleveland Clinic’s new policy to ask for copays upfront from patients before some visits is scheduled to start on Sunday. Non-emergency medical appointments would be rescheduled or canceled if patients cannot make their copays at the time of their visit.
Ideastream Public Media's Stephen Langel was the first to report on a lawsuit against the new policy, and he’s been getting some community reaction.
After receiving a huge reaction to your story on the lawsuit against the Clinic, you’ve been out talking to people about it. What have you been hearing?
People are upset, at least the majority I spoke with are. Our story about the lawsuit against the Clinic has gotten a lot of attention with more than 18,000 people viewing it. People are also reaching out by email.
I also went to the Sound of Ideas Community Tour event last week and met folks like Mike Jones, who lives on Cleveland’s West Side. He told me the policy makes him feel like the Clinic cares more about money than people.
“I don't think that's right," Jones said. "I mean, especially when Cleveland Clinic sits in an area where mostly you have impoverished people. So impoverished people sometimes [are] not going to have the money. It shouldn't even be an option.”
Though the majority of the people I spoke with oppose the policy, some, like Cleveland’s Leonard Wright, believe it’s only fair to require people to pay these fees up front.
“I think it's a good thing," Wright said. "I mean, if you go into the doctor, you know you've got to pay a copay. I pay taxes, so a lot of that medical that they're getting from taxpayers, you're getting free medical. You can't pay a $20 copay?”
Why is the Clinic making this change?
The Clinic wouldn’t tell me why in an interview. Instead, they sent me a written statement.
But Cleveland Clinic officials did speak with Cleveland City Council at a May 19 hearing, arguing they are bringing in less money and more than half of patients didn’t pay their copayments in 2024. They say this equaled about $70 million.
I spoke with Cleveland Councilperson Richard A. Starr, who represents the Central, Kinsman, Midtown and other neighborhoods. He told me he did not buy this argument.
“Cleveland is a city which is ranked one of the most poorest in the country," Starr said. "You can't just automatically come after somebody and expect them on regular checkups to have the amount of means to pay right then and there. Sometimes they've got to wait on their check to come in at the end of the month, or at the beginning of the month, to be able to pay for certain things.”
What’s covered by this new policy?
It applies to any nonemergency visit that doesn’t involve a hospital stay. For example, visits with primary care doctors or specialists, physical or occupational therapists and procedures performed in a doctor’s office.
Is this unusual among nonprofit hospitals like the Cleveland Clinic?
Upfront copayments are common practice and are becoming more frequent as health care costs, including deductibles, go up, making medical bills harder to pay, according to Richard Gundling, of the Healthcare Financial Management Association.
What does the lawsuit allege?
An activist named Cassandra McDonald filed a claim on May 20 in the Cuyahoga County Court of Common Pleas to prevent the policy from being implemented on Sunday.
McDonald, who is also a cancer patient at the Clinic, said forcing patients to pay up front may cause them to miss vital appointments and lead to medical emergencies down the road.
She said the Clinic needs to do more to work with those who have trouble making those payments.
“Give us some waivers or do something that can assist. But to demand the copayment and turn people away, that is the thing that concerns me," she said.
What’s coming next?
Councilperson Kevin Conwell, who represents Glenville and University Circle, told me that he would be meeting with Cleveland Clinic officials this week to discuss the policy in more detail, and what steps could be taken to address concerns from the community.
