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Mayo Clinic Gives Priority to Private Insurance Patients

John Noseworthy, M.D., president and CEO, Mayo Clinic
John Noseworthy, M.D., president and CEO, Mayo Clinic

Rochester, MN (KROC AM News) – Mayo Clinic says it provided hundreds of millions of dollars in services that were not paid for last year and it’s taking action to address the situation.

Mayo says services provided to patients who have health care coverage through a government program make up half of its annual total. Mayo says the unpaid portion of Medicare services last year totaled $1.8 billion. Also, the unpaid portions of Medicaid and other programs for patients who are uninsured or underinsured totaled another $550-million.

Mayo released the information Wednesday in response to a story in the Star Tribune about Mayo CEO John Noseworthy.

The newspaper reported Noseworthy recently told employees they should deal with patients who have private insurance before those who have coverage through a public program, which traditionally have lower reimbursement payments. The newspaper says Noseworthy told employees Mayo will not turn away those patients but those with private coverage should be be dealt with first.

Mayo Clinic’s full statement:

 

“Mayo Clinic has always been committed to serving patients who need us the most, regardless of insurance coverage. Across Mayo, beneficiaries of government programs, including Medicare and Medicaid, make up about 50 percent of the total services we provide. Medical need is the top factor in the decision making process for appointment scheduling. After medical need, we consider if the patient can access the care they need closer to home and often work with their local provider to provide the highest level of care locally.

Mayo provided $629.7 million in care to people in need in 2016 alone, including $546.4 million in unpaid portions of Medicaid and other indigent care programs for people who are uninsured or underinsured. The estimated unpaid portion of Medicare services across the organization was an additional $1.8 billion. To fund its research and education mission, Mayo needs to support its commercial insurance patient numbers in order to continue to subsidize the care of patients whose insurance does not cover the cost of their care.

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.”

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