Mayo Clinic in Arizona to Stop Treating Some Medicare Patients

[Synicus Maximus]

Source: Bloomberg

Dec. 31 (Bloomberg) -- The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.

More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota.

Read more: http://www.bloomberg.com/apps/news?pid=20601087&sid=aHoYSI84VdL0

[begin_within]

1. What a good citizen the clinic is!

[Donnachaidh]

2. hope every single one of those patients call McCain

And make his life miserable. :rofl:

[Djarun]

79. we have to get rid of 'socialized' medicine "my friends", "my friends", "my friends"

[area51]

3. This is awful,

but if our government can fight two wars of choice, they can afford to raise Medicare reimbursement rates. The most valuable resource in the U.S. is its citizens, and it's goddamn time that this govt. started acting like it.

[Dappleganger]

5. +1

Reimbursement rates and also how soon the hospital gets paid. Their turnaround is extremely slow.

[SharonAnn]

39. A major problem is that Medicare pays for "procedures" and the Mayo model is different.

Mayo clinics provide care by a teamwork approach, and as a consequence may spend more hours with a patient. Medicare pays only a certain amount for an "office call", a certain amount for CT scans, for X-rays, etc. The Mayo approach might involve several doctors pooling their knowledge to determine the appropriate treatment for a patient. That may involve some procedures, but it may not.

Mayo itself said this year, after participating in the discussion about HCR, that it may not be able to keep going with its successful approach to patient treatment if reimbursement continues to be procedure based.

[liberation]

45. Funny, Mayo doesn't seem that picky when it comes to not turn down the boatload of NIHS et al grants

they are very good a sucking the public tit for that though.

[johnaries]

71. That's an excellent point re: "procedure based" reimbursments

and one that I believe is addressed in the new HCR bill.

If I am reading it correctly, one of the shifts is to "results oriented" reimbursements rather than "procedure based". The current "procedure based" model can lead to Providers "milking" Medicare by ordering unneccesary procedures that the Providers know Medicare will pay for.

If I understand the new bill correctly, it seems to be adjusting to the Mayo model as you describe it.

[Yupster]

62. Of course the US can't afford to fight two wars of choice

or anything else for that matter since we are borrowing about one dollar for every three dollars we spend.

[pokercat999]

66. You forgot

this :sarcasm: or was it this :rofl: we're no longer citizens we're consumers and these comsumers aren't paying up.

[Dappleganger]

4. Mayo Jax has done this with other insurance companies before.

I know they did it with BCBS and made me pretty nervous, but they only did it for a short while and were able to negotiate and renew them again. Problem is that Medicare pays so little and so late that it puts the hospital in a financial bind. As good as Medicare is for what it's for it really does need an overhaul in many different areas.

[liberation]

44. I believe you are thinking "medicaid" not medicare

(married to a surgeon for full disclosure)

Medicare tends to be rather competitive regarding payment turn around, and their compensation is reasonable (plenty of insurers screw physicians far worse with their rates).

[katkat]

67. lib

That isn't what I hear from my doctors or read, Medicare is often below cost in reimbursements (and Congress constantly tries to lower the reimbursements, although those efforts usually come to naught.)

And plenty of doctors do not accept Medicare patients, or limit the number of them in their practice.

[panader0]

6. The Mayo Clinic in Phoenix

saved a friends life this past year. He was on Medicare and had severe oral cancer. They had to make him a new tongue. I'm glad for him that he got it done when he did, but sad for those who will be denied treatment at such a good hospital. Probably some of the rich folks complained about the poor being treated at "their" hospital.

[Crzyrussell]

40. It's more likely that medicare's

under payment and excessive lead time in paying their bills is the real reason. Many offices and clinics have done the same in order to survive.

It will probably get worse if this "reform" passes.

[JDPriestly]

7. Just wait. The only cost-cuts the proposed Senate version

of the health care "reform" bill makes are to -- you guessed it -- Medicare.

Obama has some 'splainin' to do.

[IndianaGreen]

8. There are throngs of DUers that will cheer when the Senate bill becomes law

All they want is a "W" in the Win Column, the working class be damned.

[scentopine]

10. Reward the rich, punish the non-rich, the beatings will continue - nt

[proud2BlibKansan]

13. +1

[LouKneeLib]

19. Message Discipline....

Put your smile on and march! We got our "W". There is some irony there...lol :rofl:

[mzmolly]

38. Only if the senate bill, like the house bill fixes this very problem.

http://www.aafp.org/online/en/home/publications/news/news-now/government-medicine/20091120sgrhousebill.html

I'm going to do a bit more research on the senate version.

[johnaries]

27. They are not "cuts", they are savings. Read the bill and

stop showing your ignorance. Once you know what's actually in the bill, then I'll be happy to have an informed discusson with you.

[JDPriestly]

34. How can you "save" money on health care without cutting health care costs?

Preventive measures do not cut costs fast. That is why the bill proposes to cut Medicare Advantage subsidies and other Medicare costs but makes no concrete proposals to cut other health care costs. The worst thing is that the Medicare cuts are expressed in very vague language. No one knows what will really be done except that Medicare is targeted for cuts.

[johnaries]

70. No, it does not "cut costs fast", but this bill is for the long run.

Remember,the CBO estimates are for the next 10 years.

And it actually does provide funding to make Providers more efficient and to directly cut Provider costs. It also switches the emphasis to "results-oriented" care which means that Providers can no longer "milk" Medicare for unnecessary tests, visits, etc. I know, this sounds like the beginning of "death panels", but in fact the procedures described will help ensure it is based on actual results - not what "bean-counters" expect. That's part of why it is "vague", because a procedure has to be put in place to measure results. That will take some time to implement.

[katkat]

68. johnaries

Reducing reimbursements to home health care workers is not a "savings." Not only is it a cut, but it will cost the government and us more because people who could have stayed at home will have to go into care instead, which is more expensive.

[johnaries]

69. That's corporate propaganda. Much of the savings will come

from reforming Medicare Advantage, which is run by private corporations and have resulted in billions of dollars of "overpayments" which in fact resulted in additional profits for the private companies. They are the ones behind the "cuts" propaganda.

And there will be no "cuts" in reimbursements. The "cuts" are to proposed INCREASES in reimbursements.

Also, the bill allows for increased funding in finding and cutting rampant Medicare fraud which will also save billions in the long run despite the initial increased funding.

That all makes sens to me. How about you?

[girl gone mad]

75. Mayo sure doesn't see it your way.

Mayo is expecting more cuts in reimbursements and they are firing the first shot across the bow.

Either you think you know better than one of the most esteemed clinics in the country or you are here to misinform.

Sorry, but what fool would ignore a very real warning sign from the Mayo at the advice of a stranger on the internet with a superiority complex?

[SharonAnn]

42. The Medicare "cuts" are to the extra 14% the taxpayers pay to private insurance companies

because they cost the taxpayer more than standard Medicare does.

If people want what they perceive as extra value for the Medicare Advantage programs, then they should each pay the extra 14% to the private insurance company. The taxpayer shouldn't have to pay it. The taxpayer pays for standard Medicare, that's enough.

[pattmarty]

74. I believe the cuts are to the "advantage" plans and the Bush...........

.............Medicare "reform" Where he basically increased the governments subsidies to insurance companies to make up the difference in the traditional Medicare cost and what the insurance companies charged the government.

[midnight]

9. K&R

[HughMoran]

11. Put them out of business

Fucking ass holes.

[SnakeEyes]

12. Yeah...

That damn Mayo Clinic...

[GoldenOldie]

16. Nothing New!

Mayo Clinic in Scottsdale, has been doing this for years. My younger sister was diagnosed with PAN a very rare vascular disease by Mayo in Minn and was being treated their. She had excellent insurance for 3-years after her husbands death. When she relocated to Arizona, she was followed up by Mayo, Scottsdale in co-ordination with Minn for 2-years. Her husbands insurance ran out and she then tried to use her Tucson school employees insurance and Mayo Scottsdale denied her? My spouse and I both have excellent federal insurance and it was accepted by Mayo for a few years and then when we went on Medicare as primary, Mayo denied us?

[HughMoran]

24. Elitists?

Is that how medicine should be delivered?

[freddie mertz]

14. This may be just the beginning, if current HCR legislation passes.

[chimpymustgo]

15. KILL THE BILL.

[INdemo]

61. Exactly

I still find it hard to believe that Democrats are behind this kind of legislation when it is nothing more than a giant subsidy for healthcare insurance industry.I would certainly have expected this from an Republican administration but as it looks now Obama's "change"" is "more of the same"
The healthcare reform issue would have benifited us more if there would never have been an HCR issue to begin with..

[JonQ]

21. Yeah, what have those assholes ever done for the world.

[HughMoran]

23. If they are only for those with money?

What good are they?

[JonQ]

32. Well those with money get treated

which means then that there are fewer people who need treatment right?

[HughMoran]

33. So glad you're happy that wealthy people get treatment

What about those who cannot afford to pay out of pocket?

[JonQ]

36. Perhaps they could take advantage

of some government run healthcare? Oh right, they are cutting back so that doesn't work so well anymore.

Your "ban all healthcare for everyone if even a single person can't afford it" strategy is perplexing.

How does shutting down a hospital because it doesn't cover one segment of society make us all better off? Why not build another hospital to cover the remainder?

[HughMoran]

41. The point is to pressure them to be reasonable

Are you really concerned with hospital profits over the lives of people?

[JonQ]

43. If they go bankrupt they are no good to anyone

I suppose we could enslave doctors and force them to work for free, but that medicine and equipment would still cost money. And that would make it difficult to find new volunteers to be doctors in the future, what with the slavery thing.

If you want to be outraged by this be pissed at the government for making a habit of underpaying for medical coverage. If they were paying the same rates as private insurers do you think the Mayo clinic would be doing this?

[liberation]

47. Do you know how much medicare pays vs. private insurances?

Or did they leave those tiny "facts and figures" out of your talking points?

[JonQ]

49. Reading is your friend

From the article:

The Mayo organization had 3,700 staff physicians and scientists and treated 526,000 patients in 2008. It lost $840 million last year on Medicare, the government’s health program for the disabled and those 65 and older, Mayo spokeswoman Lynn Closway said.

Mayo’s hospital and four clinics in Arizona, including the Glendale facility, lost $120 million on Medicare patients last year, Yardley said. The program’s payments cover about 50 percent of the cost of treating elderly primary-care patients at the Glendale clinic, he said.

. . . .
Nationwide, doctors made about 20 percent less for treating Medicare patients than they did caring for privately insured patients in 2007, a payment gap that has remained stable during the last decade, according to a March report by the Medicare Payment Advisory Commission, a panel that advises Congress on Medicare issues.

[HughMoran]

53. guess you were against medicare expansion then

Where do you think Medicare money comes from anyway? Why justify the exploding medical costs that exist now? Are you saying that ins. Is bad and hospitals are good? I think both share responsibility in this. Local hospital is building new buildings at a break-neck pace. Where are they getting the extra tens of millions to build these? So, let's all share the burden! Remember that you and I pay for Medicare but that hospitals and insurane are making millions - don't ask me to sympathize with those who hold the wealth.

[JonQ]

58. How exactly did you infer my opinion on medicare from this?

Just curious.

"Where do you think Medicare money comes from anyway?"

Taxes.

"Why justify the exploding medical costs that exist now?"

First prove they are exploding right now, the show where I supported increasing costs.

"Are you saying that ins. Is bad and hospitals are good?"

Having insurance is good, having hospitals is good.


"I think both share responsibility in this."

Not really. Insurance companies are paying their bills, the government is not.

"Local hospital is building new buildings at a break-neck pace. "

Suppose they would keep doing that if they had to work at a loss every year for the foreseeable future?

". Where are they getting the extra tens of millions to build these? "

Private insurance, that pays it's bills in full.

"So, let's all share the burden!"

Great, how much have you given to help someone else?

"Remember that you and I pay for Medicare but that hospitals and insurance are making millions - don't ask me to sympathize with those who hold the wealth."

And they aren't banned from seeking medical care while on medicare, just from using this one place.

[cornermouse]

60. Do you expect hospitals to have the latest equipment, the latest

treatment plans, and enough rooms to take care of an ever increasing patient load as in increased population or do you want to limit the hospital's patient load to rooms, equipment, and personnel already in existence, and send everyone else home? I'm going to point out that the equipment is extremely expensive. There's also the fact that they have had to buy software to comply with the government's plan to have all hospital and clinic records go on the computer. I believe that is also a huge expense.

And then there's the electric bill. I have no idea how much they pay but I do know that back in the 80s when I was doing books for a small hamburger joint, the electric bill was $2,000 a month. Given the jump in the cost of utilities and the difference in size, I can only guess the electric bill would probably terrify most of us.

[quakerboy]

54. My question

Do they receive other government assistance? Tax breaks, etc? If they are only for the rich, then they should not be. If they are not, then they are free to do as they like.

[JonQ]

59. Unclear

I agree though. If they are funded in part by the government then the feds can tell them what to do, or at least cut back funding if they don't cooperate. If not then they are free to do as they wish.

Hospitals are kind of funny though, they're never wholly private enterprises, the government has a much greater hand in regulating them than they do in most other industries.

[HughMoran]

63. Let's leave it there

I read your other response, but have nothing much else to offer. All I'm saying is that the health of the citizens should not be held hostage by insurance companies OR hospitals. Excluding the least able to pay is not the solution.

[JonQ]

73. k

[girl gone mad]

76. Ridiculous!

You've said some really foolish things before, but this is a new low for you.

They need to be able to keep the lights on and pay the highly trained doctors better than minimum wage. There comes a point where it's simply not worth the hassle for reimbursements that don't come close to covering expenses. This could be fixed, but the bill the Senate passed is going in the wrong direction. Time to start again. Listen to what the experts are trying to tell you this time. Or is that too fucking much to ask?

[pattmarty]

17. Here we go!!!!!! KILL THE BILL!!!!

[mzmolly]

37. The house bill is slated to address this problem.

http://www.aafp.org/online/en/home/publications/news/news-now/government-medicine/20091120sgrhousebill.html

Hopefully the final bill will have similar language?

[golddigger]

18. Kill the Bill! Kill this montrosity!

[Downwinder]

20. They located out there to service Medicare patients from Sun City.

Basically a profit center trading on the Rochester Clinic's good name.

[golddigger]

22. Hmm, the GD:P Platoon is awfully...

quiet this morning. Nursing the "Big Win" celebration hangovers perhaps?

[Cleita]

25. Something they don't explain. Are they dumping traditional Medicare or

the Medicare Advantage programs, which are operated by private insurance companies? I know in my area most health care providers have dumped the Medicare Advantage programs for paying too little, paying too late and at time denying claims and not paying at all. But they still accept traditional Medicare.

[Vinca]

26. This is an easy Congressional fix -

every provider who accepts private insurance must also take Medicare and Medicaid. End of story.

[scarface2004]

28. feds should seize this friking clinic

and force the doctors to perform services at the point of a gun....

[Haole Girl]

29. Oh great

:-(

[winyanstaz]

30. This is such depressing news...those poor people :(

[Hoyt]

31. "Cheers" to Mayo for going after the wealthy retirees in Az.

It's just another "business" decision by a large CORPORATE health care provider. In our society, one can do some pretty crappy thing under the guise of "just doing business." Interestingly, Mayo is going to keep seeing Medicare patients needing specialty care -- ie, surgeries, expensive lab and diagnostic tests, etc. If a "wealthy" Medicare patient needs primary care, they can get it from Mayo by paying a special fee. How nice.

Fortunately, there are still hundreds of thousands of physicians who continue to see Medicare patients for primary care. And those physicians continue to make decent incomes (though, not "excessive" incomes). We need more primary care (whether by physicians or alternatives), and I think there are some provisions in the two health care bills to improve that situation.

[mzmolly]

35. The new house bill is supposed fix this problem by adjusting the SGR formula.

*SGR = Sustainable Growth Rate

http://www.aafp.org/online/en/home/publications/news/news-now/government-medicine/20091120sgrhousebill.html

[freddie mertz]

46. Is this in conflict with the Senate bill that everyone seems to love so much?

I seem to think so, but am not sure.

[mzmolly]

64. I don't think anyone "loves" the Senate bill. I think what people are saying

is worse case scenario the Senate bill is progress. I don't know if the senate bill addresses this issue specifically, but it does include major funding for community clinics. And, while some medical organizations have said that they support the Senate and house bills, they also demand change in the near future on this issue.

[sakabatou]

48. Yay!

:puke:

[tomhayes]

50. So the bill that hasn't been passed caused this??

????!!!????

Or could this be a money making tactic by the management of the Mayo???

I'm willing to be it's about profits - but many people here assume it's the unpassed bill's fault.

????

[totodeinhere]

51. If they are losing money on Medicare patients, that's one thing. But...

if they are not, then it's unconscionable. A lot of medical providers say that they can't accept medicare patients because Medicare does not reimburse them enough and it's unfair for them to try to make up those losses by charging everyone else more. But the problem is, are they telling the truth about that or are they making this up in order to squeeze more money out of the Medicare program? I would like to see an independent unbiased study which could either corroborate or debunk those claims about medicare reimbursements, but so far I haven't seen any.

I do know that my own family physician will not accept any new Medicare patients but he will keep current patients who enroll in Medicare when they turn 65.

I keep coming back to what seems like an obvious fact to me. If we just initiate a European style single payer program then problems like this would go away.

[Detroit Progressive]

52. Not quite

While I do support a single payer program such as Medicare for all, it wouldn't necessarily solve the issue of doctors and hospitals not accepting patients who use the single payer program. They could simply not go along with the program and force everyone to pay cash for services. If you really wanted to solve the problem you would have to nationalize doctors and hospitals like the V.A. has done. That way not only is the insurance not for profit, but the hospitals are not for profit as well.

[Clear Blue Sky]

55. Guess they don't like losing money.

[tomhayes]

56. Is not making as big of a profit as possible losing money?

That's my suspicion here.

[Hoyt]

57. They are "losing" money only in the sense that they can . . . . .

force some of those patients to pay the $1500 annual retainer or see privately insured patients that might pay 20% more than Medicare.

A guess some of those patients -- who can't afford the retainer -- will have to go to some less well known physicians who are not so greedy they'll cut off care because they are only making $175,000 to $250,000 a year in salary after expenses.

And, like the article says -- the specialists are going to keep seeing the Medicare patients.

I think what is going on is that Mayo-Az ain't really into providing primary care because the money is in specialty care.

[SharonAnn]

65. Exactly. Medicare pays for "procedures". That's what specialists do.

[Union Yes]

72. The DLC can put this in their fuckin pipe and smoke it. How evil does one have to be nowadays..

to oppose meaningful HC reform. A strong PO at minimum.

knr

[donco]

77. Does anyone in the Arizona area

have any idea if this Mayo Clinic has refused any private insurance companies for not paying enough?

[geezerpk]

78. Mayo Florida Also Extorts

I read in another reference of thread that the Florida branch of Mayo pulled the plug on Florida BC/BS a few years back, holding their subscribers hostage until BC/BS negotiated a more lucrative contract with Mayo.