• Americans Want, Deserve Excellent Health Care; Mayo Clinic CEO Outlines How to Create It

WASHINGTON — Americans want and deserve excellent health care — whether they are visiting a primary care physician for a checkup, having surgery or need more complex care — but many wonder how they and the nation will afford it. In remarks Tuesday to the National Press Club, Mayo Clinic President and CEO John Noseworthy, M.D., outlined three steps health care providers and policymakers should take to create high-quality, patient-centered care at lower costs:

Deliver knowledge: Mayo Clinic and other health care providers must move quickly to put the knowledge gained through research into practice, benefiting patients. That is often easier said than done, in large part because of the constant flood of new information, Dr. Noseworthy says.

"Americans expect and deserve contemporary health care best practices," Dr. Noseworthy says. "They should reap the benefits of the research they support through their tax dollars."

Mayo Clinic is taking several steps to speed medical advances to patients. For example, it has created the Mayo Clinic Care Network. In the network, Mayo partners with like-minded medical practices across the country and around the world who would like to better care for their patients locally by accessing Mayo experts and expertise. In another project, Mayo is creating an electronic book of Mayo-vetted knowledge about best-practice protocols and hospital orders, patient education materials and other information that can be swiftly updated and shared across a health care organization in real time.

"We have come to realize that Mayo's most scalable product is our knowledge — both 'what we know' and also how we deliver this knowledge to patients," Dr. Noseworthy says.

Create value: High-quality care at lower costs can seem like an elusive goal, but new partnerships can make it possible, Dr. Noseworthy says.

Mayo has joined with Optum, a UnitedHealth Group subsidiary, to combine health outcomes data on 5 million Mayo patients with Optum's cost-of-care data on 109 million patients. Optum and Mayo are inviting others from all walks of health care to join the partnership, Optum Labs. The result will be a large-scale look at what works best for patients and the most efficient ways to deliver that care.

"With value as the highest, common goal, health care professionals in all care settings can turn traditional thinking on its head and find better, more affordable ways to care for patients," Dr. Noseworthy says.

Fund excellence: The government must fund innovation, create a payment system that is data-driven and recognizes the different levels of care and rewards quality and value at each level, and overhaul Medicare's payment structure, Dr. Noseworthy says.

Funding from NIH, CDC and other agencies is critical to research and discovery and economic vitality in U.S. communities, Dr. Noseworthy says. It plays a key role in identifying the best practices that can improve health care quality and drive down costs and should be supported, he says.

The next step is creating payment policies that recognize the full spectrum of care a patient may need through the course of a lifetime, Dr. Noseworthy says.

"The Affordable Care Act does much to improve primary care and to make it more accessible. But sooner or later, and particularly as we age, most people will need intermediate care and perhaps even complex care," he says. "More work is needed to create and ensure a high-quality continuum of care for Americans."

Patients with complex conditions requiring care from several specialists, and even many needing intermediate care such as knee replacement surgery, do not fit into neat categories, Dr. Noseworthy says. The U.S. health care payment system should include incentives and rewards for the proper and efficient management of complicated cases, he says.

Payment reform should also include Medicare, starting with an overhaul of the Sustainable Growth Rate, a complicated formula that determines Medicare physician payments, Dr. Noseworthy says. That includes repealing the Sustainable Growth Rate; creating a 1- to 3-year transitional reimbursement schedule using the Consumer Price Index; and establishing new, negotiated payment models that tie reimbursement to patient-centered care and quality outcomes along the spectrum of care.

"The answers to the challenges that America faces will not be simple, but if we align how we pay for care with how we diagnose and treat patients, we can reach our goal of high-value care for every patient," Dr. Noseworthy says.

To view Dr. Noseworthy's speech at the National Press Club, go to the Mayo Clinic News Network.

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