Experts divided on whether Mayo model can be replicated – MedCity Morning Read, Sept. 21, 2009

ROCHESTER, Minnesota – President Barack Obama has held up the Mayo Clinic – with its high-quality care and low costs – as an example for health systems throughout the country, but some experts aren’t convinced it’s the right model, The Washington Post reported Sunday.

The Post said that there’s “a battle” raging over whether Mayo’s success – which translates to $9 billion in annual revenue – can be replicated by other hospitals. Those who don’t think replication is possible note that Mayo attracts patients who are “wealthier, healthier and less racially diverse than those elsewhere in the country,” according to the Post.

Those who think that emulating Mayo is the way to go point to research that shows Mayo and other “model centers” in the Upper Midwest, Mountain West and Pacific Northwest spend less per Medicare patient than their counterparts in other parts of the country, the Post reported.

The newspaper noted that Mayo is a large group practice with salaried physicians who “have less incentive to perform unnecessary procedures than physicians paid on a ‘fee for service’ basis.”

But while Mayo limits its number of per-patient procedures, rates charged to private insurers and people who pay out-of-pocket are “higher than average, allowing it to thrive despite the lower Medicare spending cited by its supporters,” the Post said.

The Post reported that officials from Mayo and similar hospitals have become “determined lobbyists in their own right,” pushing for changes to Medicare that would “reward cost-effective hospitals and doctors, while punishing others.”

Perhaps they are buoyed by presidential shout-outs. This month in Minneapolis, Obama said he wants the whole country to learn from Mayo, according to the Post. And in a June letter to the late Sen. Edward Kennedy and Sen. Max Baucus, Obama wrote, “We should ask why places like the Mayo Clinic in Minnesota, the Cleveland Clinic in Ohio, and other institutions can offer the highest quality care at costs well below the national norm. We need to learn from their successes and replicate those best practices across our country. That’s how we can achieve reform that preserves and strengthens what’s best about our health care system, while fixing what is broken.”

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