Mayo Clinic in Arizona Continues to Provide Care for Thousands of Medicare Patients
Some recent media reports have inaccurately stated that Mayo Clinic in Arizona is no longer seeing any Medicare patients. This is not true.
Rather, a five-physician Mayo Clinic Arizona family practice clinic in Glendale, Ariz., has opted out of Medicare as part of a Mayo Clinic time-limited trial that will be reviewed at its conclusion. This means that Medicare will no longer reimburse Mayo Clinic for primary care services at this specific primary care facility, not at Mayo Clinic in Arizona overall. This affects only primary care office visits for the five Mayo family practice physicians at this site. Specialty care, laboratory services, imaging studies and ancillary services at Mayo Clinic are still covered by Medicare. Current Medicare patients may continue receiving primary care at the Glendale clinic but will be required to pay out-of-pocket for office visits.
Why?
Mayo Clinic loses a substantial amount of money every year due to the reimbursement schedule under Medicare. The discrepancy between what Medicare pays and our cost of providing services is particularly acute for our clinics that provide primary care. Due to these ongoing financial challenges, the five physicians at Arizona’s Mayo Clinic Family Medicine – Arrowhead in Glendale will no longer accept Medicare payments for primary care office visits. This is one of several options we are exploring to address the Medicare shortfall situation.
A Harbinger of Change
Mayo Clinic remains committed to serving Medicare beneficiaries, but we struggle to afford it. We continue to explore a variety ways to modify our practice to be able to serve Medicare patients. We are currently one of the largest Medicare providers in the country. In many ways, Medicare patients are Mayo Clinic’s ideal patients – they match the strengths of Mayo’s practice. Medicare patients are typically dealing with multiple complex health problems, which many people face as they age.
Nevertheless, decades of underfunding and paying for volume rather than value in Medicare have led us to this decision. Providers who do fewer unnecessary tests and services are paid the least, and they are the doctors and hospitals which will go out of business first if we don’t change the payment system.
That is why Mayo Clinic strongly supports health insurance reform and health care delivery reform. Health care delivery reform in the patients’ best interests means changing the payment system to reward value — defined as better outcomes, better safety, better service and lower cost. Better value results in fewer tests and decreased overall costs.
As leaders in Washington work on the final details of the health care reform plan, Mayo Clinic remains firmly committed to reform because the status quo is not sustainable.
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A Medicare patient who chooses to stay at Mayo’s Glendale clinic will pay about $1,500 a year for an annual physical and three other doctor visits, according to an October letter from the facility. Each patient also will be assessed a $250 annual administrative fee, according to the letter. Medicare patients at the Glendale clinic won’t be allowed to switch to a primary care doctor at another Mayo facility.
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4 Trackbacks
[...] A post on Mayo’s Health Policy blog said some media reports incorrectly reported the organization was not seeing any Medicare patients in the state. Instead, Mayo’s decision impacts patients who see “only primary care office visits for the five Mayo family practice physicians at this site.” [...]
[...] primary care at the Glendale clinic but will be required to pay out-of-pocket for office visits. Medicare and Mayo Clinic in Arizona Health Policy Blog If you read the link, the clinic also talks about the medicare schedule. That schedule as referred [...]
[...] seeing any Medicare patients. This is not true,” spokesperson Lee Aase writes in a Mayo Clinic Health Policy Blog, posted Jan. [...]
[...] Rather, a five-physician Mayo Clinic Arizona family practice clinic in Glendale, Ariz., has opted out of Medicare as part of a Mayo Clinic time-limited trial that will be reviewed at its conclusion. This means that Medicare will no longer reimburse Mayo Clinic for primary care services at this specific primary care facility, not at Mayo Clinic in Arizona overall. This affects only primary care office visits for the five Mayo family practice physicians at this site. Specialty care, laboratory services, imaging studies and ancillary services at Mayo Clinic are still covered by Medicare. Current Medicare patients may continue receiving primary care at the Glendale clinic but will be required to pay out-of-pocket for office visits. ( see http://healthpolicyblog.mayoclinic.org/2010/01/05/medicare-and-mayo-clinic-in-arizona/ ) [...]