Mayo Clinic Preference For Patients With Private Insurance Spurs Probe From Health Officials
The reported move of Mayo Clinic to stamp its preference on patients with commercial insurance has triggered a strong reaction from senior health officials who dubbed the action as disconcerting.
Minnesota Department of Human Services Commissioner Emily Piper said her department is very concerned about the Mayo CEO’s order and is looking how that will be put into action.
The official said it is looking into the matter to know whether it is tinkering with any of the existing laws on human rights.
Leaked Video Transcript
A leaked video transcript of Mayo CEO Dr. John Noseworthy’s counsel to the employees on the new policy was obtained by the media and triggered a storm in the healthcare circles.
The authenticity of the video has been confirmed by Mayo.
“I was really surprised,” Piper said while adding that the DHS still expects the Mayo Clinic to honor its commitments to enrollees in public programs.
She said the Mayo CEO has been sent some communications for which response is awaited.
Piper said it is unusual on the part of a hospital boss to openly promote the cause of privately insured patients at the expense of government funded patients.
Piper hinted that DHS will also relook at its existing contracts with Mayo and also probe the complaints lodged by Medicaid patients about “dissatisfactory service at the Mayo.”
Meanwhile, the Mayo staffers invited the commissioner for a discussion. Though Mayo’s action will not affect a large number of patients, the selective strategy might be reflecting the financial pressures faced by Mayo due to federal health reforms.
In the video, the CEO says the clinic will take patients irrespective of payer source. However, Noseworthy wanted the employees to apply discretion when two patients are referred with similar conditions. Then the “priority should be accorded to those with private insurance.”
“We’re asking … if the patient has commercial insurance, or they’re Medicaid or Medicare patients and they’re equal, that we prioritize the commercial insured patients enough so … we can be financially strong at the end of the year to continue to advance our mission,” the CEO said in the video recorded late last year.
Mayo Defends Action
Mayo said the preference for commercial insurance is a way to bolster patient numbers and a means to subsidize patients whose insurance is inadequate to cover the cost of their care.
A statement by Mayo said medical need will be the first priority in the matter of scheduling patients. The clinic’s statement claimed that Medicare and Medicaid still constituted 50 percent of the total services.
In 2016, Mayo provided more than $600 million in care to patients, in which $500 million is in unreimbursed care for Medicaid patients and charity.
Medicare patients had their services billed up to $1.8 billion which was still not reimbursed.
Serious Violation Of Law
Discrimination of public program patients through denial or delay of care at the emergency room is a serious offense, according to Tom Barker, a lawyer at Foley Hoag.
However, the right of a hospital to order its elective patients on the basis of payer source is a gray area, he added.