The Observation Deck

Ok...so I started thinking about this.... so say you cannot be treated at the new Urgent Care center (UGH) and you have to be transported to another hospital. And say you are transported to a hospital/doctor that is NOT in your network. Now your insurance will not pay for that as again NOT network... does that mean the city will now cover my bills since they closed the place my insurance does accept? I can barely afford what I have now, add the extra costs of this and I will lose everything.

The new facility will act as a screening center for Cleveland Clinic.

If you're poor and lack insurance (or are Medicaid), they will send you to Metro.
If you have good insurance, they will send you to Fairview.

Another example of the widening gulf between rich and poor.

I believe that Lakewood EMS charges around $6.00 or $6.50 per mile for an ambulance. Add that to your charges of possibly having to take two ambulances.

Missy: If a patient seen in the Lakewood ER needs to be transferred to an in patient or in system hospital the ER will arrange for the transfer to the facility of the patients choice. So if you are seen at the Lakewood ER and need transfer to UH or Metro they will arrange for that transfer. I confirmed this with the ER Director.
The LFD billing rate per mile is $12.00. This is low compared to other EMS systems. We generally adjust our rates every 2 years and base the fee schedule by taking an average of the other agencies that our billing company represents. We will be evaluating our fee schedule in 2016.

If I understand correctly, the original question had to do with health insurance companies and their preferred networks of hospitals. What happens in the case of someone being transported from Lakewood to a hospital that is not "in-network"?

For example, a year or so ago, Cleveland Clinic hospitals were "out of network" for at least some HealthSpan coverage. (I believe emergency rooms were excepted.) This has changed.

The information about the ambulance costs is good to know.

Hello Scott Gilman

I respectfully submit that the extra costs of having to be transported twice will be born by the patient and their insurance who would have only 1 EMS bill were he or she taken from their Lakewood home to an ER attached to a Lakewood Hospital. I have already spoken with people who have dealt with this reality.

Not to mention the even more important "time is tissue".

Lakewood is not getting a "good deal" here, no matter what City Council's rhetoric proclaims. Our healthcare has been diminished --- watered down. Furthermore, the EMS protocol you provided adds credibility to the argument that a Free Standing ER (without an attached hospital) is NOT a FULL SERVICE ER. It just cannot be. And the cost to insurance companies and patients will go up. Some insurers are already suing in other states on this very issue.

You and your TEAM are just superb and I have seen you in action for my family's needs. BUT you cannot compensate for the fact that our officials have given away our full service healthcare for a Medical Office Building and an ER that is NOT guaranteed in the future. It is clear by the Master Agreement that services will be reconfigured periodically & are NOT guaranteed by this agreement. When the Lakewood ER is found not to be as profitable as CCF wants it to be - (& I predict that they will make this happen) - then in 2018, this ER will be quickly reduced to an Urgent Care or even an Express Clinic as the residents of Sagamore Hills experienced.

The Lakewood Hospital was demolished through a program of PLANNED OBSOLESCENCE called the DECANTING PLAN. This Free Standing ER will suffer the same fate through a PLANNED OBSOLESCENCE. The citizens os Lakewood and surrounding areas are the losers.

pam

Pam, we do have a great Fire Department. However, lets not forget that our fire chief has chosen to fall in line with the mayor. Sure, two ambulance rides, if you survive is great! The mayor is not going to pay for your extra ambulance ride. I wish our city workers would have the guts to stand up to this fool and give us the REAL story. Either the chief fears his job, or it appears he has taken a part in the master plan! ( $$$$$$$ )

Pam the question posed was not about ambulance transport. If a resident calls 9-1-1 LFD will do everything possible to get that patient to the closest and most appropriate hospital. In some cases it will be the Lakewood ER, in other cases it won't. To a casual observer that is hearing a call on a scanner, the transport to Metro of someone with a minor injury such as a fall would seem wrong, but it is done based on the complete assessment of the patient. No one hears the whole story on a patient on a scanner.

The question whether a patient will get 2 bills if transported to the Lakewood ER and then needs transport to an in patient facility is not as simple as some people would make it sound. I cannot answer how all the different insurance providers would address two transports. What is evaluated by insurance companies on the bills generated by LFD is the medical need for the transport. If the medical need is not documented correctly by the paramedics or the ER staff, the insurance provider can reduce or deny payment on the bill. LFD has trained and continues to train our staff to make sure the medical need is properly documented. If there is an issue with a bill creating a hardship to the patient, the city has policies in place to address such issues and has had those policies since 1999.

As for the other comment, I do not fear for my job nor have I been part of any master plan. I only post information based upon my years of experience or that I have obtained from first hand conversation.

The question is ...you get to the ER and they decide you need to be transported to an inpatient hospital...who pays for that? My insurance will NOT pay for that. And I cannot afford any more bills. (2 grand a month just to have insurance and an 8 grand deductible....I am barely getting by now) What happens when you are transported to another facility and your insurance won't pay for that ER room visit since you were just in one? Or that doctor you are seeing is a non network provider. How does this help those on fixed incomes...

Missy Limkemann wrote:The question is ...you get to the ER and they decide you need to be transported to an inpatient hospital...who pays for that? My insurance will NOT pay for that. And I cannot afford any more bills. (2 grand a month just to have insurance and an 8 grand deductible....I am barely getting by now) What happens when you are transported to another facility and your insurance won't pay for that ER room visit since you were just in one? Or that doctor you are seeing is a non network provider. How does this help those on fixed incomes...

1. One answer is: it does not help people on fixed incomes--it hurts them--and City Hall doesn't care--they are pursuing the Wreck Center--Active Lying agenda--but that is not Chief Gilman's doing--in the scheme of policy making it seems he has to make the best of the rubble the stooges have created for him.

2. The other answer (which is inextricably intertwined with the first one) you already have eluded to---many insurances won't pay much of the free standing ER/ED's charges. Why? Because the reality is that the freestanding ER/ED performs less service for the same price as a full service ER/ED. (google this and you will see that you are right) Why should the insurance company subsidize the Clinic who just cleared $481M in profits last year by providing less service for the same fees? Its a war among giants and the little guys and gals get screwed.

3. The final answer is: just don't pay the Clinic and all the other bills you get from their "partners"--they will write it off--it will actually count as "charity" which might make them look better. So you're actually helping the Clinic by not paying them.

My biggest concern is that what Lakewood has now is NOT an Emergency Room. MLM gave the Urgi Care this name right from the beginning and CCF advertises it as an ER. We have no trauma surgeons, no surgery, you basically get sent to another hospital at your own expense for everything other than a sore throat and a hang nail. I wish that the city administration would call it what it is instead of making it seem like we have the Lakewood Hilton ER. Also, what happens if we have several patients that would be in the need of the mobile stroke unit at one time? What if the stroke unit is in route to CCF Downtown? Does another unit come out? How long could that take? How many mobile stroke units does Lakewood have at its convenience? How many other CCF facilities do we share these mobile stroke units with? No matter how pretty you make it look, anyone with a real emergency needs a real emergency room.

The Lakewood Emergency Department can stabilize and treat/disposition all issues, no exceptions. Stroke, MI, chest pain, headaches, falls, lacerations - if they can't fix it, they will get you to the provider who can. With backup from the Cleveland Clinic and Northern Ohio Trauma System (NOTS), they can evaluate, stabilize, and appropriately disposition patients with complex medical and surgical needs. There was recently a victim of a life-threatening gunshot wound that was dropped off at the front door of the ED. The patient survived because of the excellent teamwork and high quality care he received at Cleveland Clinic Lakewood.

Severe trauma or traumatic amputations would have been transferred to Metro or Fairview for vascular surgery/trauma attention before hospital closed.

For time sensitive illnesses, the ED uses an "auto launch" system coordinated through the Main Campus. The critical care transfer team is mobilized within minutes and can be door to door in as little as 15 minutes. The acute treatment team at the receiving hospital is mobilized and OR/cardiac catheterization lab readied if needed for definitive management at same time. This applies to Acute MI, strokes, and aortic dissections, all of which require rapid assessment and treatment. Serious trauma is transferred through a similar system coordinated through NOTS, and patients are quickly transferred to Metro or Fairview.

Poisonings are treated in ED. They have access to an arsenal of reversal agents and are immediately ready to provide supportive care for the acutely poisoned patient. The ED staff contacts poison control just like any other ED would, and manages the patient according to a toxicologist's recommendation. Once stabilized, the patient is transferred via critical care workflow (coordinated by staff at Cleveland Clinic and its receiving hospital network) to an ICU or other inpatient bed if needed.

There is one mobile stroke unit in the Cleveland area with a second one planned. LFD will not delay transport of the patient to wait for the stroke unit. The treatment for that patient would be no different than before the hospital closed. The stroke unit is another option that is available to provide service to the community.

Bottom line, it still is not as safe as the best alternative,which is to have a hospital right here in our city with 51,000 residents. When I was out campaigning this past year for both myself, SLH and Michael Skindell, I had the opportunity to speak with a few Paramedics and Fire Fighters. Not surprising, they think that this hospital deal was extremely bad and definitely would put our residents in harms way. They agreed that there could be possible deaths associated with the added travel time. I only wish that our Fire Chief would have done what I believe would have been the right thing and that is to stand up for the residents of Lakewood instead of backing Summers. I believe what the administration did is criminal and anyone working at city hall could have filed a complaint with the Attorney General of the State of Ohio. To go along with this scam is sickening!

Lori Allen wrote:
"What if the stroke unit is in route to CCF Downtown?"

Lori,

Let's be frank about this. There is no CCF Downtown. The CCF "Main Campus" begins at East 86th street. That address is no more "downtown" than West 86th street!

No, this is the power of marketing at it's best, once again. The CCF would rather you NOT think that their "Main Campus" is on the east side of Cleveland, which it no doubt is! Judging from all the police protecting Toby's gathering the other morning, they know exactly where they are!

Similar to the question at hand in this thread is, I wonder how many of my family's doctors, now in the INA building, will stay here in Lakewood now that the Clinic has closed the inpatient portion of the hospital? Months ago, I read that the net result of this deal will be a "healthcare desert' in Lakewood. The more I think about it, the more it seems likely that will be the case. Thanks Mayor Summers! Please take your "transformative healthcare" or your "transformation of healthcare" or whatever you want to call today and put it where the sun don't shine!

How many more options in your agenda are going to fight to eliminate for us in the next four years?