The Mayo Clinic has three areas of activity -- patient care, education, and research. Mayo's chief administrative officer Shirley Weis says the needs of the patient always come first.
But in 2008, the number of patients who came to the Mayo was flat. And more of them came with Medicare coverage.
At Mayo's campus in Rochester, 3 percent more of their patients were Medicare. Overall, the clinic lost $765 million on those patients.
Mayo's chief financial officer Jeff Bolton says that wasn't the only slip for the not-for-profit health care provider. Mayo lost 18 percent, or another $700 million, in investments.
"While there is really nothing very good you can say about an 18 percent loss for the year, on a relative basis when you compare it to industry benchmarks, it was favorable -- and actually by about 5 percentage points. The indices lost about 23 percent," said Bolton.
The pension plan took another hit. It is now $1.2 billion short of being fully funded.
And expenses ballooned. Mayo opened a new hospital in Florida, so expenses grew at 7.5 percent, while revenue grew at 4.5 percent.
Projects like health information publishing and clinical laboratory reference services helped balance the books. External funding helped, too. In total, those brought in $364 million.
Mayo's Shirley Weis says the clinic will continue to tighten its belt through efficiencies. The company will also cut capital projects and remain selective about filling open positions.
At this point, Mayo has no plans to lay off workers or to change the types of patients accepted.
Weis and Bolton both say Mayo remains in a strong position, and that while these figures aren't uplifting, they are comparably good.
They expect that Mayo will meet its goal of a $1.25 billion endowment by the end of 2009.