Mayo Clinic questioned after CEO says private insurance should be 'prioritized'

20 March, 2017, 10:43 | Author: Eloise Marshall
  • Report: Mayo Clinic to cherry-pick patients with commercial insurance over Medicare and Medicaid patients

The controversy arose out of a speech to Mayo Clinic employees late past year in which Noseworthy said the hospital would prioritize privately insured patients in circumstances when they are seeking care for a similar condition to those with government insurances.

In response to a video transcript obtained by the Star Tribune in which Mayo CEO Dr. John Noseworthy explained the policy to employees, DHS Commissioner Emily Piper said in a statement early Thursday afternoon that her department has a lot of questions about "how it will implement the directive". Mayo is regarded as a medical leader in so many ways that Noseworthy's public acknowledgement that private pay patients will sometimes be served before others may be seen as a signal to other hospitals that it's OK to do the same thing.

"Patient medical need will always be the primary factor in determining and setting an appointment".

As Human Services commissioner, Piper is focused on ensuring access to health care for those enrolled in public programs. However, Noseworthy wanted the employees to apply discretion when two patients are referred with similar conditions. As our percentage of government pay patients has grown, we are working in turn to grow the number of commercially insured patients we are seeing. "In fact, about half of the total services we provide are for patients who have government insurance, and we're committed to serving those patients".

"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."

Medicaid critics argue doctors are less likely to accept new patients with Medicaid than with private insurance and that Medicaid patients typically have worse outcomes than privately insured patients.

Nevertheless, the nonprofit still generated substantial profits in 2016: $475 million. Sonneborn speculated that Medicaid coverage expansions might have allowed more people to seek out Mayo's famed Rochester hospital in recent years. However, the law also decreased the number of uninsured, which can be costly to hospitals.

Patients with government insurance, especially Medicare, don't doom all hospitals. "We would never make a statement worded like that". "I don't think they should be shamed for saying it", he said. Avik Roy, a conservative health policy expert and president of the Foundation for Research on Equal Opportunity, collected evidence to back up these claims in a February report for Congress.

In Minnesota, Gov. Mark Dayton has proposed a 5 percent rate increase for Medicaid payment of physician services, which could ease some of the pressure on hospital systems.

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