The following is an editorial from the Rochester Post-Bulletin:
Editorial: Mayo emphasizes value in health reform
3/6/2009 7:15:02 AM
Paying for value vs. fee-for-service.
If Mayo Clinic has its way, these terms will become an integral part of the national conversation about health care reform. And make no mistake: Mayo wants the nation to know that it is taking a leading role in the reform effort.
That message was sent when Jeff Korsmo, formerly Mayo’s chief administrative officer, became the executive director of its Health Policy Center. His full-time job is to share Mayo’s vision — which emphasizes efficiency, patient satisfaction and outcomes — in Washington and around the country. Today the clinic has the ear of both the Obama administration and Congressional leaders.
But Dr. Denis Cortese, president and CEO of Mayo Clinic, doesn’t want Mayo to linger in the national spotlight any longer than is absolutely necessary. “If this goes right, people will take ownership of these ideas and sell them as their own,” he said Wednesday during a meeting with the Post-Bulletin’s editorial board. “Right now, health care reform is all about ideas — and how many people are making our ideas their ideas.”
Mayo is striking while the iron is hot. The economic crisis has brought a new sense of urgency to the health care reform effort, and President Obama is wasting no time. He hosted a health care summit Thursday in Washington, and the economic stimulus package includes hundreds of millions of dollars that will be used to expand health insurance coverage nationwide.
Cortese praised Obama’s efforts, but he insisted that insuring everyone is only one step in the reform process — and a relatively easy one when compared to the other tasks that lie ahead.
“We don’t want to end up with everyone insured but in a fee-for-service system,” he said. “If we don’t pay for value, then nothing else works.”
This isn’t a new argument, of course. Medicare, the biggest fee-for-service provider in the United States, has long been criticized for its inefficiency, for encouraging doctors to perform unnecessary X-rays, tests and redundant services.
Mayo prefers a model in which providers can be fairly compensated for giving patients better care, with fewer errors, fewer doctor visits and fewer hospital stays. That’s paying for value, and Cortese would argue that not only does it cost less than a fee-for-service model, but it also improves patients’ quality of life, which should be everyone’s goal.
The problem, of course, is getting health care providers, insurance companies, pharmaceutical companies and state and federal governments to agree on what would be a fundamental shift in both the theory and practice of medical care in the United States. That task proved impossible in the 1990s under President Clinton, and we hold out little hope that the current Congress would fare much better.
That’s why Mayo is proposing an independent, non-partisan health board (similar to the Federal Reserve) that would set the guidelines under which people could select basic insurance coverage and receive sliding-scale insurance subsidies based on their income levels. That’s a good start, but we suspect that the health board will need powers and responsibilities that go far beyond those of an insurance regulator.
But we’re getting ahead of ourselves. In the weeks to come, we’ll have the opportunity to weigh in on insurance reform, drug costs, the benefits and problems of single-payer systems and whether individualized medicine is a practical option in a nation of 300 million people.
For now, we’re simply proud that Mayo Clinic is leading the way.