Guest opinion: Mayo Clinic: health care should go on a diet
Mayo Clinic has advice for the U.S. health care system: Trim the fat.
Earlier this month, the Medicare Payment Advisory Commission, an independent agency that advises Congress on issues related to the Medicare program, reported that regional differences in the use of health care services for Medicare beneficiaries continues to vary significantly. At the extremes, this means that Medicare patients in Miami receive nearly twice as many services as patients of comparable health living in La Crosse, Wisc.
Overuse of services bloats the U.S. health care bill. This must be drastically reduced, particularly because there is little evidence that higher service use translates into better patient results. In fact, data from the Dartmouth Institute and the Commonwealth Fund continue to show that lower cost care is of higher quality. When a diagnosis is correct the first time, proper treatments are chosen, and complications and medical errors are avoided, health care costs are lower because patients spend fewer days in the hospital, have fewer unnecessary tests and procedures performed and experience higher quality outcomes. Similarly, when chronic diseases are well-managed and care is well coordinated, patient health is increased while costs are reduced as unneeded doctor visits and hospital admissions are avoided.
All patients across the country deserve this type of high-value health care. Doctors, hospitals and other providers need to take the lead in trimming the waste out of the system.
If trimming the fat is indeed a goal for American health care, then the system needs a "personal trainer" - groups or organizations that have already shown that high-value health care practices save money and are good for patients. It is in this spirit that Mayo Clinic announced Tuesday it is launching a new initiative: the Center for the Science of Health Care Delivery. This center will design, implement, measure, and disseminate high-value health care best practices.
One specific example of the type of work the Center will conduct includes a collaborative among Cleveland Clinic, Dartmouth-Hitchcock, Denver Health, Geisinger Health System, Intermountain Healthcare, Mayo Clinic and The Dartmouth Institute for Health Policy and Clinical Practice. This initiative represents a first-of-its-kind collaboration in which the institutions will share data on outcomes, quality and costs across a range of common and costly conditions and treatments, like knee replacement and diabetes. The group will determine how to best deliver care to patients with challenging conditions and will rapidly disseminate actionable recommendations to doctors and hospitals across the country. In addition to achieving better patient results, the collaborators aim to reduce the per capita cost of these conditions.
A renewed institutional commitment to the science of health care delivery can help drive high-value health care practices across the country, and we encourage all health care providers to commit to focusing on quality and efficiency in an effort to better care for patients and reduce overall costs at the same time.
However, if the government wants to permanently bend the cost curve, difficult and permanent changes will need to be made to what "feeds" our current system - how doctors and hospitals are paid. The government and insurance companies need to stop paying providers for tests and procedures that do nothing to improve a patient's health. The mind set needs to focus on keeping people healthy, better managing their chronic diseases and staying out of the hospital.
With each new year, millions of Americans resolve to lose weight but often struggle
against inertia to accomplish the goal. Likewise, U.S. health care has difficulty moving beyond the status quo. Now is the time to explore new payment policies, research innovations and private-public partnerships that will help us emerge from our rut and get lean - starting in 2011.
Earlier this month, the Medicare Payment Advisory Commission, an independent agency that advises Congress on issues related to the Medicare program, reported that regional differences in the use of health care services for Medicare beneficiaries continues to vary significantly. At the extremes, this means that Medicare patients in Miami receive nearly twice as many services as patients of comparable health living in La Crosse, Wisc.
Overuse of services bloats the U.S. health care bill. This must be drastically reduced, particularly because there is little evidence that higher service use translates into better patient results. In fact, data from the Dartmouth Institute and the Commonwealth Fund continue to show that lower cost care is of higher quality. When a diagnosis is correct the first time, proper treatments are chosen, and complications and medical errors are avoided, health care costs are lower because patients spend fewer days in the hospital, have fewer unnecessary tests and procedures performed and experience higher quality outcomes. Similarly, when chronic diseases are well-managed and care is well coordinated, patient health is increased while costs are reduced as unneeded doctor visits and hospital admissions are avoided.
All patients across the country deserve this type of high-value health care. Doctors, hospitals and other providers need to take the lead in trimming the waste out of the system.
If trimming the fat is indeed a goal for American health care, then the system needs a "personal trainer" - groups or organizations that have already shown that high-value health care practices save money and are good for patients. It is in this spirit that Mayo Clinic announced Tuesday it is launching a new initiative: the Center for the Science of Health Care Delivery. This center will design, implement, measure, and disseminate high-value health care best practices.
One specific example of the type of work the Center will conduct includes a collaborative among Cleveland Clinic, Dartmouth-Hitchcock, Denver Health, Geisinger Health System, Intermountain Healthcare, Mayo Clinic and The Dartmouth Institute for Health Policy and Clinical Practice. This initiative represents a first-of-its-kind collaboration in which the institutions will share data on outcomes, quality and costs across a range of common and costly conditions and treatments, like knee replacement and diabetes. The group will determine how to best deliver care to patients with challenging conditions and will rapidly disseminate actionable recommendations to doctors and hospitals across the country. In addition to achieving better patient results, the collaborators aim to reduce the per capita cost of these conditions.
A renewed institutional commitment to the science of health care delivery can help drive high-value health care practices across the country, and we encourage all health care providers to commit to focusing on quality and efficiency in an effort to better care for patients and reduce overall costs at the same time.
However, if the government wants to permanently bend the cost curve, difficult and permanent changes will need to be made to what "feeds" our current system - how doctors and hospitals are paid. The government and insurance companies need to stop paying providers for tests and procedures that do nothing to improve a patient's health. The mind set needs to focus on keeping people healthy, better managing their chronic diseases and staying out of the hospital.
With each new year, millions of Americans resolve to lose weight but often struggle
against inertia to accomplish the goal. Likewise, U.S. health care has difficulty moving beyond the status quo. Now is the time to explore new payment policies, research innovations and private-public partnerships that will help us emerge from our rut and get lean - starting in 2011.
VERONIQUE ROGER is director, Center for the Science of Health Care Delivery; PATRICIA SIMMONS is medical director of government relations, Mayo Clinic, Rochester, Minn.
