- On October 20, 2025
Update on ProMedica Negotiations and Broker Communications
Topic: Network Updates | Companies: Medical Mutual, Paramount, Mutual Health Services | Segment: Individual, Medicare, Small Group (1-50), 51-99, 100+, MEWA
As shared previously, Medical Mutual is negotiating with ProMedica Health System regarding network status for the 2026 plan year. Medical Mutual remains committed to conducting these discussions in good faith, with the ongoing goal of securing the highest value and quality of care for its members.
Their established process is designed to guide negotiations with the objective of reaching fair compensation for services provided. As part of this approach, both parties agreed to engage an independent third party to validate supporting data to help determine an appropriate reimbursement level. While Medical Mutual has upheld its commitment to the mutually agreed-upon process to resolve this business issue, ProMedica has chosen to involve broker partners, employees, and patients through letters, billboards and digital media — seemingly to increase pressure and gain leverage in negotiations by pushing Medical Mutual toward terms they believe are unreasonable.
Medical Mutual is proud to serve as Ohio’s hometown health insurer, committed to providing affordable healthcare solutions to local employers and the communities they support. Medical Mutual has long been a trusted partner in Northwest Ohio, working to ensure healthcare remains accessible and sustainable. Medical Mutual’s support of ProMedica’s growth in the region — including the acquisition of Paramount Health Plan in 2024 — reflects their dedication to strengthening local access to care. They’ve consistently negotiated fair and reasonable rates and supported ProMedica’s efforts to expand services. However, over the past four years, we’ve already absorbed more than 36% in compounded increases. Now, ProMedica is requesting an additional double-digit increase, all of which would compromise affordability for the very individuals and families we are committed to protecting.
We recognize that rising healthcare costs impact both insurers and providers. However, simply passing those increases along without restraint is not a viable solution. Many local businesses with self-funded plans would bear the financial burden, while fully insured employers and individual members would face higher premiums, deductibles and out-of-pocket costs. That approach threatens the long-term affordability and sustainability of care.
Medical Mutual remains focused on reaching a fair and balanced agreement that serves the best interests of its members and the broader community. However, if an agreement cannot be reached, we are fully prepared to support our members through a seamless transition to high-quality, in-network providers such as Mercy Health, University of Toledo Health, Toledo Clinic, Firelands Health, NOMS and others.
Medical Mutual’s responsibility continues to be to its policyholders, and they are working on its policyholders’ behalf to minimize increases in their healthcare costs.