Mayo Clinic to give preference to privately insured over Medicaid, Medicare patients

Mayo Clinic CEO John Noseworthy, MD, told employees in a recent speech that the Rochester, Minn.-based system will "prioritize" patients with private insurance over Medicare and Medicaid beneficiaries if the patients have similar conditions and seek care at the same time, according to the Minneapolis Star Tribune.

"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," Dr. Noseworthy said in the videotaped speech, according to the report. 

Dr. Noseworthy said Mayo will continue to take all patients, regardless of payer source, and the policy will not apply to patients seeking emergency care.

Mayo's move to slightly shift its payer mix indicates the financial pressures Mayo and other health systems across the nation are facing due in part to federal health reform. Under the ACA, Medicaid enrollment has dramatically increased, but Medicaid typically pays much less for medical care than private insurers. 

In a statement to STAT, Mayo said Medicaid and Medicare beneficiaries make up about 50 percent of its patient population.

"Balancing payer mix is complex and isn't unique to Mayo Clinic. It affects much of the industry, but it's often not talked about. That's why we feel it is important to talk transparently about these complex issues with our staff. We will continue to discuss these complicated issues and work to find solutions that benefit our patients," said Mayo in the statement to STAT.

More articles on healthcare finance:

How Partners HealthCare's miscalculations altered Medicare payments nationwide
Dana-Farber's Medicare funding at risk due to overreliance on Brigham and Women's
Average claim denial rate for large hospitals, by region

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars