MetroHealth to Tighten Charity Care Eligibility, Boost Insurance Enrollment Amidst $1 Million Daily Cost
CLEVELAND – MetroHealth, Cuyahoga County’s safety-net hospital, is taking steps to address a rapidly escalating financial burden from charity care, now exceeding $1 million per day. The system announced plans to encourage greater insurance enrollment and possibly tighten eligibility requirements for free care, according to reports from Becker’s Hospital Review, Signal Cleveland, cleveland.com, and MetroHealth statements.
Charity care costs have doubled since 2022,prompting MetroHealth to seek “strategies to reduce this burden without compromising our role,” the system stated. A key component of the plan involves requiring uninsured patients to meet wiht financial counselors to explore coverage options – including Medicare, Medicaid, and the Health Insurance Marketplace – before qualifying for charity care.Currently, Cuyahoga county residents earning up to 300% of the federal poverty level (approximately $96,000 for a family of four) are eligible for free care at MetroHealth. The system is considering lowering that threshold to 250%, aligning with policies at Cleveland Clinic and University Hospitals. Patients earning above the revised threshold would still receive discounts, though potentially at reduced rates.
“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. Board Chair E. Harry Walker, MD, emphasized the goal of “a more equitable sharing of costs so that the federal general financial aid program can focus on those with the biggest and deepest needs,” as stated during an August board meeting.
These changes are part of a broader stabilization effort at MetroHealth,which recently laid off 125 employees,primarily in administrative roles,and froze some nonclinical hiring in July. The system is also closing six outpatient locations in October, consolidating services into larger facilities, while concurrently planning to open a new outpatient health center with a 24/7 pharmacy in 2026.
“Any association, especially one facing financial challenges, must constantly look at ways to operate more efficiently,” said MetroHealth President and CEO Christine Alexander, MD. “This move is a continuation of our efforts to right-size our footprint by aligning our resources with our priorities.”
MetroHealth maintains its commitment to providing care regardless of a patient’s ability to pay, but stresses that the current financial trajectory is unsustainable. Further details regarding the finalized plans will be released as they become available.
