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Mayo Clinic policy on Medicare, Medicaid raises questions

The Mayo Clinic, praised by the White House as a model for healthcare reform, is no longer accepting some Medicare and Medicaid patients.

October 13, 2009|Washington Post

WASHINGTON — The Mayo Clinic is no longer accepting some Medicare and Medicaid patients, raising new questions about whether it is too selective to serve as a model for healthcare reform.

The White House has repeatedly praised Mayo and other medical centers, many of which are in the Upper Midwest, that perform well in Dartmouth College rankings showing wide disparities in how much hospitals spend on Medicare patients.

The centers have capitalized on their status to insert into healthcare legislation provisions that would result in higher Medicare payments for hospitals that do well on the rankings, while punishing those elsewhere -- mostly in big cities and the South -- that spend the most per Medicare patient.

But some skeptics -- healthcare analysts as well as politicians and medical officials in states that would be hurt by Mayo's proposals -- argue that low Medicare spending by Mayo and others is driven by the lack of diversity and poverty in their patient population.

They say Mayo's low-cost image belies the high rates it charges insurers and private payers.

Mayo announced late last week that its flagship facility in Rochester, Minn., would no longer accept Medicaid patients from Nebraska and Montana. It will now accept Medicaid recipients from only Minnesota and the four states that border it.

As it is, 5% of Mayo's patients in Rochester are on Medicaid, which is well below the average for other big teaching hospitals and the 29% rate at the other hospital in town.

Separately, the Mayo branch in Arizona put out word a few days ago that under a two-year pilot program, it would no longer accept Medicare for patients seeking primary care at its Glendale facility.

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