The Mayo Clinic has started limiting the number of Medicare and Medicaid patients it admits and critics argue that such restrictions have made Mayo too selective to serve as a model for health-care reform. The renowned center is one of several that has won praise from administration officials, who point out that it does well in the Dartmouth College rankings that show disparities in how much hospitals spend on Medicare patients, The Washington Post
reports. "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," according to the Post. Some skeptics, including health-care analysts, politicians and medical officials in states that don't fare well under 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."
The Mayo Clinic announced late last week that its facility in Rochester, Minn., which has patients from throughout the Midwest and West, "will now accept Medicaid recipients only from Minnesota and the four states that border it. ... Separately, the Mayo branch in Arizona -- the third leg of the Mayo stool, with the Rochester clinic and one in Florida -- 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." Mayo officials made the decisions because of low payment rates by Medicare and Medicaid rates and said Medicare reimbursement rates should be changed in reform (MacGillis, 10/13).