The renowned 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 health-care reform.
The White House has repeatedly held up for praise 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 model centers have capitalized on their status to insert into health-care legislation provisions that would result in higher Medicare payments for hospitals that do well on the Dartmouth rankings while punishing those elsewhere -- mostly, big cities and the South -- that spend the most per Medicare patient.
But some skeptics -- health-care 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 is belied by the high rates it charges insurers and private payers.
Mayo announced late last week that its flagship facility in Rochester, Minn., will no longer accept Medicaid patients from Nebraska and Montana. The clinic draws patients from across the Midwest and West, but it will now accept Medicaid recipients only from Minnesota and the four states that border it. As it is, 5 percent of Mayo's patients in Rochester are on Medicaid, well below the average for other big teaching hospitals, and below the 29 percent rate at the other hospital in town. (continues at NY Times)