Mayo Clinic's stand on Medicare and Medicaid-?Model for the country

This news item seems to show another side to Mayo Clinic who has received nothing but praise from some quarters regarding their reputation as a quality center who provides care for less.

From the news report:

Mayo announced late last week that its flagship facility in Rochester, Minn., will no longer accept Medicaid patients from Nebraska and Montana. The clinic draws patients from across the Midwest and West, but it will now accept Medicaid recipients only from Minnesota and the four states that border it. As it is, 5 percent of Mayo's patients in Rochester are on Medicaid, well below the average for other big teaching hospitals, and below the 29 percent rate at the other hospital in town.

The Washington Post article continues:

Separately, the Mayo branch in Arizona -- the third leg of the Mayo stool, with the Rochester clinic and one in Florida -- put out word a few days ago that under a two-year pilot program, it would no longer accept Medicare for patients seeking primary care at its Glendale facility. That facility, with 3,000 regular Medicare patients, will continue to see them for advanced care -- Mayo's specialty -- but those seeking primary care will need to pay an annual $250 fee, plus fees of $175 to $400 per visit.

I would not having good standing to criticize their refusing some Medicaid patients,I did the same thing in my practice as did most of my partners. I am puzzled how they can charge more to Medicare Patients seeking primary care.I thought if you "accepted" Medicare patients you agreed to their payment schedule and could not bill for the balance.

Mayo has been held up as a model for high quality, efficient health care but what sort of model is it that is moving to see fewer Medicare patients? What will their stance regarding the public option patients be (should there even be a public option)?