Monday, January 4, 2010

Hold the Mayo

I was asked by a patient today while the Mayo Clinic group in Airzona would drop Medicare. I told him I did not know the official answer but I can speculate. First, there is a 21% cut in how much Medicare pays doctors . Presently, private insurance pays about 1/3 more than Medicare did even before this cut. So, if can replace your Medicare patients with patients that have private insurance, you automatically make more. So, with the Medicare cuts, you almost have to drop them to stay even. Further, by opting out of Medicare, or becoming non-participating, you bill the patients directly and they are responsible for the hassle of trying to bill and get paid by Medicare. You can also charge what you want instead of only getting what Medicare will pay. Since Medicaid is tied to Medicare, you get out of that as well. You also get rid of all the Federal red tape that is CMS.

I guess the real question is, with the Medare cuts and the hassles of dealing with the goverment, why is the rest of Mayo still participating.


Peter said...

Excellent analysis.

Mayo is just one of the organizations following the bandwagon ridding themselves from the burdens, hassles, and poor payment from Medicare and Medicaid. I expect it to continue through the rest of that institution and the rest of the country.

SeaSpray said...

That's so sad for the patients ..I'm guessing most of whom worked hard during their life..paid into it and believed they'd have decent insurance.

I understand why providers would drop them and can appreciate the relief in not having to deal with the red tape.

I feel for the elderly patients though. Something has to be done.

They need an advocate for mdcr patients ..a voice that can counter these cuts that hurt the patients?

Can you imagine elderly patients having to deal with the red tape? Most would not understand and they would not know to fight for a claim. They would assume it is what they have to pay ..when in reality it is mdcr's responsibility.
I have an aunt I have been helping. She lives on ss and has a very tight budget. She incurred a hospital bill over 100,000.00
She was given a bill from the hospital, while still a *sick* pt in said hospital. they hadn't even billed her mdcr yet! But they billed her for what they said the balance would be. She was so worried. they never offered her charity care. I worked there and knew they should have and got that process going. She was billed again and I had to practically beg her not to pay anything yet because after talking with the dept am certain she will get 100% write off. I really had to convince her to hold off because I know that all she saw was that bill, their letters and feels she will be doing something wrong if she doesn't. She's not looking for a free ride but I know how hard she's worked, her circumstances and that program was meant for people in her predicament.

But many people don't have anyone acting in their behalf an I just think they will be taken advantage of by mdcr...and ins companies too.

Why does it all have to be so complicated? I think to discourage and cause people ..even medical providers to give up.

I wonder how much money could be saved because time and paperwork saved if billing/claim reimbursement was more straightforward vs having to go 3 rounds for a claim in which the average person would not have the knowledge to navigate through?