It is rare that a hospital leader would espouse a strategy that promotes access for privately insured patients at the expense of publicly funded patients, Piper said.
Those comments attracted the attention of many groups, including the Minnesota Department of Health and Human Services.
Noseworthy declined via Mayo spokespeople to be interviewed for this story. Across Mayo, beneficiaries of government programs, including Medicare and Medicaid, make up about 50 percent of the total services we provide.
"We can provide the care they require for complex medical issues", he said. The tendency of those programs to offer low reimbursement rates has led to predictions that hospitals would cherry-pick patients who would be better for their bottom line.
In his speech, Noseworthy said a recent 3.7 percent surge in Medicaid patients was a "tipping point" for Mayo.
"If we don't grow the commercially insured patients, we won't have income at the end of the year to pay our staff, pay the pensions, and so on", Noseworthy said.
Nevertheless, the nonprofit still generated substantial profits in 2016: $475 million. She said that in her view, nothing that is happening with the health care law on the federal level changes those requirements. He said the policy would only affect a small number of patients and it would not not apply to emergency care. Caseworkers already take insurance information when patients call for appointments, he noted.
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Medicaid critics argue doctors are less likely to accept new patients with Medicaid than with private insurance and that Medicaid patients typically have worse outcomes than privately insured patients.
Baumgarten added that complaints about the rise in Medicaid patients should be tempered by the corresponding decline in uninsured patients.
Gov. Mark Dayton and Lt. Gov. Tina Smith both expressed concern Friday about a Mayo Clinic policy that in some cases gives priority to privately insured patients over people on public programs. Roughly half of Mayo's patients are covered by Medicare and Medicaid; there will be times when they will have to wait, or wait longer, for tests and surgeries.
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. "We forever have been a hospital treating a high abundance of Medicaid patients". "I don't think they should be shamed for saying it", he said.
The numbers: Mayo Clinic's revenue has grown by more than 6% annually on average since 2009, reaching $11 billion in 2016 (making Mayo Clinic bigger than national companies like Hertz and Biogen). Noseworthy met with president-elect Donald Trump late past year to discuss such reforms.
Other experts expressed sympathy with the hospital's perspective.