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Why doesn t Mayo Clinic accept Medicare?

That's right, for every patient over age 65, it costs the hospital more to deliver care than the government reimburses. That is why Mayo Clinic has said it will not accept Medicare payments for primary care physician visits. Mayo gets it. Nationwide, physicians are paid 20% less from Medicare than from private payers.

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Medicare, the government insurance company for everyone over age 65 (and for the disabled) pays fees to primary care physicians that guarantee bankruptcy. Additionally, 70% of hospitals in the United States lose money on Medicare patients. That’s right, for every patient over age 65, it costs the hospital more to deliver care than the government reimburses. That is why Mayo Clinic has said it will not accept Medicare payments for primary care physician visits. Mayo gets it. Nationwide, physicians are paid 20% less from Medicare than from private payers. If you are not paid a sustainable amount, you can’t make it up in volume. It just doesn’t pencil out. Mayo lost $840 million last year on Medicare. Since Mayo is considered a national model for efficient health care, if they are losing money it doesn’t bode well for the rest of us who are much less efficient and who have fewer resources for integrated patient care. Instead of Medicare payments for clinic visits, Mayo will start charging patients a $2,000 fee for patients to be seen at their Glendale, Arizona clinic. Much like a “retainer”, this fee will cover an annual physical and three other doctor visits. Each patient will also be assessed a $250 annual administrative fee. Primary care physicians are on the front line of patient care and senior patients are the most time consuming. The average Medicare patient takes 11 different medications. Just refilling and coordinating the medication can take up an entire office visit, without addressing other health concerns. I grant all Medicare patients a 1/2 hour visit because I would be chronically behind if I didn’t. After paying office overhead, I am broke with Medicare. I do not welcome the 65th birthday of my patients, but I continue to see them because I love my senior patients. No kidding, I really love being their doctor. They are grateful and respectful and have interesting health conditions. I am able to see them because I make my income from my administrative position and I have private pay patients. Sad but true. Unless we have true payment reform that values primary care and pays for coordination of care, I fear Medicare patients will not find enough willing physicians who accept Medicare in the future.

Tony Brayer is an internal medicine physician who blogs at EverythingHealth.

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Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation's best hospitals in its annual “America's Best Hospitals” survey.

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Cleveland Clinic is here for one reason: to take care of patients. We are known for exceptional care delivered by multidisciplinary teams. We challenge ourselves to get better each year. Our goals are to touch more lives, relieve suffering and provide every patient the best care and experience.

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There are nearly 60,000 Cleveland Clinic caregivers around the world. We are the largest employer in Northeast Ohio and the second largest in the state. We promote teamwork, inclusion and integrity. We strive to make Cleveland Clinic the best place to work and grow.

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Cleveland Clinic’s community benefit goes beyond healthcare services. As an anchor institution, we promote the physical and economic health of our neighborhoods. We are building a future for health education and workforce development that will enhance the region for generations.

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Cleveland Clinic is a nonprofit organization. All revenues beyond expenses are reinvested in our mission. We care for the organization as if it were our home, by securing its financial health, using resources mindfully and bringing our services to as many people as need our care.

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