Pushback on Medicaid, Medicare part of a trend.
By Jeremy Olson Star Tribune
Mayo Clinic’s chief executive made a startling announcement in a recent speech to employees: The Rochester-based health system will give preference to patients with private insurance over those with lower-paying Medicaid or Medicare coverage, if they seek care at the same time and have comparable conditions.
The number of patients affected would probably be small, but the selective strategy reveals the financial pressures that Mayo is facing in part due to federal health reforms. For while the Affordable Care Act has reduced the number of uninsured patients, it has increased the share covered by Medicaid, which pays around 50 to 85 cents on the dollar of the actual cost of medical care.
Mayo will always take patients, regardless of payer source, when it has medical expertise that they can’t find elsewhere, said Dr. John Noseworthy, Mayo’s CEO. But when two patients are referred with equivalent conditions, he said the health system should “prioritize” those with private insurance.
“We’re asking … if the patient has commercial insurance, or they’re Medicaid or Medicare patients and they’re equal, that we prioritize the commercial insured patients enough so … we can be financially strong at the end of the year to continue to advance, advance our mission,” Noseworthy said in a videotaped speech to staff late last year. The Star Tribune obtained a transcript of the speech, and Mayo has confirmed its authenticity.
Mayo is hardly alone in trying to build its privately insured clientele. Hennepin County Medical Center, for example, is building a new ambulatory center and North Loop clinic in part to attract privately insured patients.
But in the diplomatic world of health care and politics, it is rare to hear a hospital leader espouse any strategy that promotes access for privately insured patients at the expense of publicly funded patients.
“The most interesting thing isn’t that it’s happening, it’s that a high level executive actually said it out loud,” said Mat Keller, who monitors health care policy and hospital finances for the Minnesota Nurses Association.
Noseworthy declined via Mayo spokespeople to be interviewed for this story. Spokesman Karl Oestreich said Mayo remains committed to publicly funded patients — who make up half the health system’s business — even with the new policy.
“We can provide the care they require for complex medical issues,” he said. “However, we need to balance requests from these patients with their specific needs — if it’s necessary for them to come to Mayo — as well as the needs of commercial paying patients.”
