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Mayo Clinic CEO: Medicare Payment Model Is a ‘Catastrophe’

By Jacob Goldstein, WSJ, Jul 22, 2009

Denis Cortese, the doc who runs the Mayo Clinic, swung by the Health Blog’s office today to talk health reform. His bottom line, which he’s been repeating in public in the past few days: The big health-care bill unveiled last week in the House of Representatives misses a key opportunity to change the way Medicare pays for health care.

What’s more, Cortese argued, adding a new public plan that covers more people and pays for care the same way as Medicare won’t work, because the rapid rise in health costs will continue. “A Medicare model is a catastrophe,” he said.

The basic argument Cortese and the Mayo Health Policy Center have been making for a while now is a variation on a familiar theme: Doctors and hospitals should be paid on the based value they provide rather than simply paid a fee for every procedure they do. Those who have better outcomes with less risk and fewer costs to the system should be rewarded.

Yes, it’s tough to value care for some conditions, but there are others where there are solid, risk-adjusted measures to evaluate patient outcomes. And Medicare could go a long way by starting with a few common conditions, such as diabetes and heart disease, Cortese said.

“Why don’t we give instructions to the Health and Human Services Secretary to start value-based purchasing right now in Medicare?” he said.