More Mayo, Please

By Gorman Gorman

Jul 23, 2009 1:54pm

As we covered earlier this week, the Health Policy Blog of the Mayo Clinic — whose work President Obama constantly praises — criticized the House Democrats' health care reform bill.

While praising the "positive provisions…including insurance for all and payment reform demonstration projects – the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients," the Mayo blog stated. "In fact, it will do the opposite."

The blog continued: "In general, the proposals under discussion are not patient focused or results oriented. Lawmakers have failed to use a fundamental lever – a change in Medicare payment policy – to help drive necessary improvements in American health care. Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither. The real losers will be the citizens of the United States."

At his press conference last night, President Obama was asked about the Mayo Clinic's "problems with the House proposal saying they're not focused enough on patients and on results."

The president said "I think it's important to note that the Mayo Clinic was initially critical and concerned about whether there were enough changes in the delivery system and cost-saving measures in the original House bill.  After they found out that we had put forward very specific mechanisms for this MedPAC idea, this idea of experts getting the politics out of health care and making decisions based on the best evidence out there, they wrote in their blog the very next day that we actually think this would make a difference."

The president was referring to a follow-up post from Mayo about the creation of an Independent Medicare Advisory Council.

"We applaud the direction of this proposal," the clinic said. "We view favorably the concept of an independent body that can move Medicare to a 'value-based payment' model.  An independent Medicare advisory commission focused on defining value, measuring it, and finding ways to pay for value could have significant, positive impact on health care for the long term.  While we think the proposal’s timeline of 2014 is too long to wait to see value-based reforms, we look forward to working with the administration on refining and strengthening their new proposal. This, and other, bold concepts have the potential to “bend the cost curve” in U.S. health spending without compromising health."

The Mayo Clinic's spokeswoman, Dana Sparks, goes on to tell Roger Sergel, the managing editor of ABC News' medical coverage, that the "Mayo Clinic still believes the bill needs to go further…be bolder…and address the current payment system problems.  Mayo can’t support a ‘Medicare-style’, price controlled public plan.  As Dr. (Denis) Cortese (the President and CEO of Mayo) says, before we start new ones we should fix the ones we have."

She referred us to Cortese's appearance last night on Charlie Rose:

Sparks wrote: "It’s been ‘interesting’ to see how some media depict Mayo’s reaction, saying the Clinic is against or ‘trashing’ the Obama plan…just because we were strong enough to raise questions and concerns.   Mayo is focusing on policy — not politics — Dr. Cortese says we’ll be at any table that addresses ‘the value’ issues.Mayo wants universal coverage, is wholeheartedly in support of President Obama’s drive for reform, agrees that the 'status quo' is not an option for consideration…and supports the overall legislative direction, especially the language (Minnesota Democratic Sen. Amy) Klobuchar and (Wisconsin Democratic Rep. Ron) Kind have introduced in the Senate and House."

Sparks said that "What ‘changed’ this week, was the Administration offered up and embraced the IMAC idea…which we have been proponent of all along.  Mayo would like to see it ‘married’ to the House bill.  Once we agreed with that, it gave the appearance that we had ‘backed down’ or ‘softened’ and that’s not the case.  IMAC, as (Office of Management and Budget director) Peter Orszag says, could free Congress from the burdens of dealing with technical issues like Medicare reimbursement rates."

- jpt

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