Each year, the U.S. Spends about $ 3 trillion on health care – $ 9,225 per person – which is about a fifth of the American economy. Once one of the most stable sectors of the US economy, health care is in the throes of unprecedented change, driven by a powerful mix of technological development and mandate that includes costs and will improve quality. Is at the forefront of this change Mayo ClinicOne of the nation’s premier health systems, which cares for over 1.3 million patients annually in its hospitals and many more indirectly through the Mayo Clinic Care Network. The network is made up of 35 independent hospitals or systems that have satisfied Mayo quality standards and have been given access to Mayo intellectual support and for highly complex patients who cannot be treated at home, fast-track clinical Services.
The president and chief executive of the Mayo Clinic, yesterday’s keynote speaker at the American News Hospital, president and chief executive officer of the Mayo Clinic, spoke with the US News about some of the changes affecting the nation’s health care system and tens of Told Mayo’s approach to improving health care for thousand patients. – and outside – its walls. (Interview is edited for clarity and length.)
What are the two or three changes in the largest health system compared to the previous year?
Dr. John Noseworthy is the President and CEO of Mayo Clinic.Courtesy Mayo Clinic
There is a very strong focus on transparency [uncover] A lot of sins, [shedding light on] Quality and safety and all the criteria that consumers are increasingly paying attention to – such as payers. And we are expecting, by process measures, [Did the doctor prescribe aspirin?] For results [How did the patient do?], Although it is still in its early days. The results we measure are death, collapse, foreign objects. [following surgery], Hospital-acquired infections, and those types of things. More complex aspects of health care, such as efficiency, accuracy, and suitability of care, are more difficult to measure, but we will find ways to get there.
[Measuring outcomes] is very important; This is a reasonable direction to go for medicine. Patients should know [their hospital’s performance]. Actually, the hospital administration should know about it [the push to develop better ways of measuring their performance], So they can drive higher quality cars, which will eventually turn into payment for better results. This is the general direction the government is going in, and the payers are [such as self-insured employers and insurance companies] will follow. It’s huge, it’s a good thing, and it’s a big change. [The big question is] Just how that change is handled, so that proper encouragement and sharing of data is everywhere.
Being Critically Important What other developments do you attack?
As Secretary, the merger of four of the five largest private insurers is clearly big news. [of Health and Human Services Sylvia] Burwell’s announcement that C.M.S. [the Centers for Medicare and Medicaid Services] Going to pay for [improved] Result in a very aggressive time frame. Repeal of the formula for sustainable growth [which calculated the fees that Medicare paid doctors] is also [propelled the development of] The alternative payment model and everyone found it very difficult to work together.
Integration has become a powerful force in the healthcare market. What are your thoughts on this trend?
For the private sector, such as bio-tech, pharma, device companies and so on, solutions coming together to work closely with payers and providers Stem-innovation country it’s a good thing. … but [a push by hospitals to] Be big so that we can get purchasing power on the business side of life – in the end and not pass it on to the patient as better care, [a problem]. We have decided No To go with consolidation – to get bigger than owning more hospitals, so we can extract costs and win. Our knowledge is a much more patient-focused, front-line approach to imparting knowledge to the patient so that they can get better care along with saving money in this way.
Can you talk about how mayo accomplishes this?
For 150 years we have been developing team-based care, with salaried physicians focusing on the patient. This is our culture; This is what we have done forever. As we have grown over the years, and have expanded our reach, that scaling [up] It is difficult. … Even when you get really good people – and fortunately everyone in medicine wants to do the right thing – the system is not set to be promoted.
With our human mission, how do we share what we have learned? We decided that the best way to digitize it. We put those care models in a careable data system called “Care Mayo Expert”, which can be accessed as a customer for members of the care network. If you’re a brain surgeon, and I’m a neurologist, and [someone else] There is a psychiatrist, how do we share dementia patients who only need to say, a shunt? What are the important problems when you take the three of us together? We put it in a digital format, so that when it is discovered by an internist, or neurologist or neurosurgeon – someone who says, “Gee, I’m just a neurosurgeon, I wish I had a neurologist to talk to – [he or she] You can pull it up and say, “In Mayo, that’s how they manage it.”
We have thousands of such scenarios that are readily available on the desktops of physicians and nurses in the health system. Immediately they were thrown into one [scenario] To resemble a team for a specific patient problem. When they do this, they can also see who created this knowledge set at the Mayo Clinic and how to contact them with additional questions. This has enabled us to keep 80 percent of the patients in. [their local hospital], Whether in Pikeville, Kentucky, or Santa Barbara, [California], Or Hanover, New Hampshire. If that information is not enough, then of course, they can call; We will do a video consultation. Ten or 15 percent of patients eventually need to leave. [to Mayo] Due to the complexity of their care, but we share our knowledge.
What further harm do you see for patients?
The narrow network of providers put patients at a major disadvantage. They cannot leave the network until they pay out of pocket, because they are too complex [conditions] Obviously going to be exceptionally expensive and not being covered by insurance. The American public does not yet know when they buy [certain kinds of low-cost] Insurance products, when they go out of network, have to cover a lot of costs.
Are there implications for hospitals?
Payers are shifting financial risk to expensive care that is not given to providers – payers are trying to “de-risk” themselves. But a hospital system only has a fixed amount of money to care for a population. They do not want many patients to leave their system and move elsewhere for another opinion because they will lose control of the expenses of caring for that patient. [They keep control by restricting patients] For a narrow network. It sounds good if you call it fast from a business point of view. For patients, especially those in need of complex care, not all systems are deep enough to manage their concerns. [Their doctors and hospitals] That kind of problem cannot be seen with the frequency of the center of excellence, which sees them all the time. This can cause great harm to that patient; One of the centers of excellence strategies is to show that, even if we are not in other people’s networks, we can actually save them money because we see and do this stuff all the time [can care for them] Safely and efficiently.