The number of patients affected would probably be small, but the selective strategy reveals the financial pressures that Mayo is facing in part due to federal health reforms. For while the Affordable Care Act has reduced the number of uninsured patients, it has increased the share covered by
Mayo will always take patients, regardless of payer source, when it has medical expertise that they can't find elsewhere, said Dr.
"We're asking ... if the patient has commercial insurance, or they're
Mayo is hardly alone in trying to build its privately insured clientele.
But in the diplomatic world of health care and politics, it is rare to hear a hospital leader espouse any strategy that promotes access for privately insured patients at the expense of publicly funded patients.
"The most interesting thing isn't that it's happening, it's that a high level executive actually said it out loud," said
Noseworthy declined via Mayo spokespeople to be interviewed for this story. Spokesman
"We can provide the care they require for complex medical issues," he said. "However, we need to balance requests from these patients with their specific needs -- if it's necessary for them to come to Mayo -- as well as the needs of commercial paying patients."
More than 300,000 Minnesotans have gained coverage in the last three years from
In his speech, Noseworthy said a recent 3.7 percent surge in
"If we don't grow the commercially insured patients, we won't have income at the end of the year to pay our staff, pay the pensions, and so on," he said, "so we're looking for a really mild or modest change of a couple percentage points to shift that balance."
Mayo reported a sharp increase in the amount of unreimbursed costs related to
The Mayo policy would not affect emergency room care, because federal law requires hospitals to treat patients who show up with urgent needs. Nor do Mayo officials expect it to be applied often, because it would be rare for equivalent patients with different insurance to show up at the same time and force a choice.
"So I can imagine when they ... sit down at their computer scheduling system to see when the first opening is available for a nephrology consultation," he said, "and if they have two requests, maybe they give the first opening to the guy with good medical insurance and maybe they say, 'Well, for the person with
Baumgarten added that complaints about the rise in
Overall hospital revenue in
The association nonetheless strongly supports the expansion of
"There has always been pressure on the commercial [insurance] side to make up for losses on the government side," he said. "Some of the pressure has shifted from uncompensated care to losses on
Data from the
The hospital hasn't considered policies that prioritize privately insured patients, though, said
Mayo also is discouraging patients with public insurance from traveling long distances to
At the same time, Mayo is participating in the larger debate on health care reform, advocating for state and federal policies that would reward hospitals for efficient rather than wasted care -- a Mayo hallmark. Noseworthy met with president-elect
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