CLEVELAND, Ohio — MetroHealth Medical Center will begin charging its poorest patients small fees for care, while at the same time expanding who gets discounted care, The Plain Dealer reported Wednesday night.

It’s a move to modernize the way MetroHealth has managed its patients and puts the system “into the 20th century,” Gary Benjamin, a community organizer with UHCAN Ohio, told the newspaper.

Under the plan, which begins next month, MetroHealth’s poorest patients who formerly received free care will pay $5 or $10 for each visit. In turn, MetroHealth will offer discounted care to people 400 percent above the federal poverty level.

MetroHealth used to only offer that service to those 200 percent below the poverty level. The new discount policy actually mirrors efforts at the city’s bigger systems – Cleveland Clinic and University Hospitals Case Medical Center, according to the paper.

MetroHealth’s new plans will work in concert with a stricter emergency-department policy, which it enacted in mid-2008. Under the plan, patients who visit the emergency department but don’t need immediate care will be guided to Metro’s community clinics. Patients who still opt for emergency care will pay $75 for the visit.

The overall plan should affect 37,000 patients, according to The Plain Dealer.

Emergency-room care remains one of the more vexing issues for hospital systems because of its expense but also because of the needs of the uninsured.

Sisters of Charity Health System’s new chief financial officer said recentlythat emergency departments are one of the primary places most health systems can save money. Earlier this month Chicago BioMedicine announced amid staff cuts that it would triage non-emergent patients that visited its emergency department.

And MetroHealth, which has gone through a series of reforms and layoffs in the past year, warned in February that it would consider more job cuts to keep pace with rising costs.

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