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Facing a possible civil rights investigation, Mayo Clinic’s chief executive is backpedaling from statements he made to employees about prioritizing the care of privately insured patients over those on Medicare and Medicaid.

Dr. John Noseworthy issued a press release late Friday saying that he regrets that the wording he used caused confusion about the hospital’s commitment to serving patients with government insurance. He sought to correct the record after Minnesota regulators said they are looking into potential legal violations based on his comments.

In his statement, Noseworthy said: “Patient medical need will always be the primary factor in determining and setting an appointment. In an internal discussion I used the word ‘prioritized’ and I regret this has caused concerns that Mayo Clinic will not serve patients with government insurance. Nothing could be further from the truth. In fact, about half of the total services we provide are for patients who have government insurance, and we’re committed to serving those patients.”


The controversy arose out of a speech to Mayo Clinic employees late last year in which Noseworthy said the hospital would prioritize privately insured patients in circumstances when they are seeking care for a similar condition to those with government insurances. He said the policy would only affect a small number of patients and it would not not apply to emergency care.

“We’re asking … if the patient has commercial insurance, or [if] 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,” Noseworthy said at the time. Mayo Clinic made $475 million in profit in 2016, down from $612 million three years prior.


His bold pronouncement, reported this week by the Minneapolis Star Tribune, reflects the growing unease among hospital executives who are watching profits shrink due to steady increases in the number of government-insured patients. Medicaid, whose enrollment has increased dramatically under the Affordable Care Act, traditionally pays hospitals significantly less than commercial insurers.

While Noseworthy walked back his prior comments, it is common for hospitals to shift operations to treat patients with insurance that pays them more money. He said it is important to talk about such matters openly in light of the financial pressures facing hospitals. “Changing demographics, aging of Americans and budgetary pressures at state and federal government pose challenges to the fiscal sustainability in healthcare today,” he said in his statement Friday. “While these discussions are uncomfortable, they are critical for us to be able to meet the needs of all of our patients.”

Noseworthy’s candor caught the attention of Minnesota Department of Human Services Commissioner Emily Piper. She said she was surprised and concerned by the comments, and has questions about what they really mean and how Noseworthy’s directive would be carried out. The Associated Press reported that Piper’s department is looking into whether there are possible violations of civil and human rights laws.

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  • This most likely explains why Mayo, Jacksonville, would not accept me as a patient. After I told them I was on Medicare they told me that they were booked out a year and not taking new patients.

    • Ive been treated well at Mayo Clinic in Arizona for 15 years..Im now on Medicare and all of a sudden I can’t get an appointment, they say they are booking two medicare patients per month per doctor. That eliminates any on time health care. so disappointing to be treated so indifferently because your older and on medicare

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  • Mr Noseworthy you need to leave the medical system. You no longer understand that all people need care. If they are on Medicare or Medicaid or private insurance, people need equal care. What you need to do is leave before you do harm to thousands of people who look to the Mayo Clinic for help! Resign before you are fired!

    • @jvm64 In other countries it certainly is. Australia for example, which has a public system which will accept every human physically in the country (even illegals). And a private system which is almost pointless and only used for electives like cosmetic surgery or advanced dental, or guaranteeing a private bed for a non elective issue.

  • This explains why my father had to wait 7 weeks to get into mayo. He could get into the VA quicker.

  • I live in southeastern MN and we have the highest insurance in the nation due to Mayo Clinic dominating the medical scene with few choices of other coverage. My husband and I have supporting Mayo through donations of time, money, and hard-work. I am discusted by the Mayo Clinic’s new views of it’s patients. We seem to be only monitary units instead of the patients that the Mayo brothers and the sisters cared enough about to create the wonderful medical facility that it once was. Now that they have convinced the city and state government that monies would be well spent from MN public tax dollars for their Destination Medical Center, they can be selective I guess.

    • exactly. Mayo’s operating margin was 4.3 percent last year. Average for a not-for-profit hospital is 2.2%. They just want to make more money.

    • NON-profit, means all the profit is invested in the company such as newest research, cancer and radiology treatments, expensive equipment

  • As someone now on ‘government insurance’, I’d like to remind Dr. Noseworthy that I pay quite a lot for that insurance. Medicare B is about $100 per month, and is also federally taxable. I also pay $136 per month for Medex,and $20 per month for Part D, with copay a for individual medications. There have been times in my life when I paid less for ‘commercial’ insurance than I do now for ‘government’ insurance. How will Dr. Noseworthy regard us Medicare holders if premiums for Medicare holders increase 25% as now threatened? Shame on the Mayo Clinic, one of the wealthiest private medical institutions in the country for its lack of care for its patients. Hospitals, in my view, are not meant to be profit-making businesses.

    • It is a bit more complicated than that. While I would agree that hospitals should be in it primarily for the patients and not for the money, they still have to pay the bills. If the people who want the services of the hospital cannot pay those bills, that hospital will not be able to provide the services. How much is good healthcare worth? That is a question we all have to answer, as does our society.

  • I live in Arizona. I am plagued by multiple orthopedic challenges. As well, I have been diagnosed with several auto immune disorders that have been verified as having been triggered by a failed medical device being implanted, and then four years later, subsequently rejected (that has since been taken off the market ). Over two decades later I am faced with the possibility of a left leg, above the knee, amputation being necessary. As a result of my many health care needs, and the issue of most of my care providers who I am currently being seen by, at present, admittedly being “out of their depths” in the planning and coordination of my care; one of my doctors thought it prudent to refer me to the Mayo Clinic (located in Scottdale Arizona) . Both myself, and my Dr, had finally completed all of the necessary steps in order for me to qualify by review for a necessary prior authorization by my insurance company (I’m on both Medicare and Medicaid). This process had taken nearly a year to complete, during which time I had chosen to suspend any further diagnostic testing and turned down multiple suggestions for several preliminary treatment options while I waited in anticipation of being accepted as a patient at the Mayo Clinic. Finally; the day came, I was told that everything was in order and I was in the clear to make a phone call to set up an appointment. My phone call ended after being told that my insurance was inadequate, and I would not be accepted there as a patient. I had asked prior to ending my call if perchance exceptions were ever made? I had stated that my situation was complex in nature and I felt it was worth asking. I was all but lectured for having asked, and then told that no exceptions are made, that only cash payment, or a superior insurance plan would qualify me for care. I then hung up, feeling totally demoralized. After reading this article, I am now wondering if I should call back?

    • Yes–but not Mayo. Try Minnesota Department of Human Services Commissioner Emily Piper. I’m sure they’d love to hear that story…

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