Denis Cortese, M.D., Mayo Clinic president and CEO, and Jeff Korsmo, the Chief Administrative Officer for Mayo Clinic Rochester and Director of the Health Policy Center, followed the participant voting with an overview of the HPC activities from the last couple of years.
Why is Mayo Clinic engaging in this? Demographics alone will force Medicare reform, and how Medicare is reformed will affect Mayo and its patients. Dr. Cortese alluded to a quote from Jerry Garcia:
“Somebody has got to do something, and it’s just incredibly pathetic that it has to be us.”
The importance to US:
- Too many citizens without insurance protection
- Huge opportunities in efficiency and effectiveness
- The needs of the patient come first
Dr. Cortese says we need a Learning Health Care System, because the diffusion of information is far too slow. Right now the best-performing aspect of health care is in breast cancer, where patients get the state-of-the-art treatment and recommendations about 85 percent of the time. For atrial fibrillation (an abnormal heart rhythm), it’s more like 15-20 percent.
Dr. Cortese says we should focus on:
- Value - outcomes, safety and service, divide by cost over time.
- Integration and Coordination - lower costs, better outcomes, better quality. Wisconsin ranks highly in coordinated care. People on the East coast haven’t experience the kind of coordination and integration that people in the Midwest take for granted.
- Individualized Medicine - tailoring therapies to the individual, based on the genomics revolution
- Science of Health Care Delivery - System engineering for health care.
Dr. Cortese calls for payers to “Pay for Value” and reward providers that provide the best value. Medicare is the largest insurance company in the world, and it reward delay in diagnosis, incorrect diagnosis and bad outcomes.
“Pay for Peformance” is not the same as “Pay for Value.” Don’t just reward process steps, but the outcomes for patients. You can read an article about the differences here.
Dr. Cortese also calls for “Insurance for All” and favors something like the Federal Employees Health Benefit Plan model. All people own insurance, and everyone should participate. Employers can still contribute to insurance, with government contributing on a sliding scale for individuals who can’t afford it.
Jeff Korsmo says Mayo’s role is convening the discussion, and keeping patients at the center. He then gave a whirlwind tour of Mayo’s convening and outreach activities, including linking with AARP, SEIU, AMA and many other national organizations. The Health Policy Center Web site has more background.
