Speaking at the National Press Club in Washington D.C. on March 21st, Denis Cortese, MD, President and CEO of the Mayo Clinic, in Rochester Minnesota, stressed that this country needs to create a healthcare system that works. Some say the system is broken, but this is a fatal way to think because then you think that you can fix the system. A new healthcare system needs to be designed with reforms to ensure the future of quality patient care.
He said that people want their medical professionals to be able to predict risks for illnesses, prevent major illnesses, present wellness programs, diagnose illnesses accurately and timely, be able to control chronic illnesses, and people in general want to enjoy a good quality of life.
According to Dr. Cortese, one of the first steps is to come together to build learning systems. As the Institute of Medicine has pointed out, too many patients are subject to medical errors. In our system today, patients don’t always get the right advice 100% of the time. Learning systems are needed to connect information to enable the professionals to have best medical evidence available at all times to make the right decisions. With the right information and teamwork, medical care will be done right the first time.
Over the past two years, the Mayo Health Policy Center used an integrated approach to help find healthcare reform solutions. The Center over two years brought together more than 400 national thought leaders for discussions and to help guide the health reform process. The ideas discussed at these sessions concerned universal insurance coverage, coordinated care, providing high-value healthcare to patients, and payment reform.
Dr Cortese outlined some of the resulting Mayo Health Policy Center’s ideas on how to advance health reform:
- Health insurance and basic healthcare needs to be available to all Americans regardless of their ability to pay. Individual ownership of health insurance should be encouraged, with sliding scale subsidies provided for people with lower incomes
- The U.S. needs to move from employer-based insurance to portable, individual-based coverage. Employers could still help finance a portion of their workers healthcare expenses but they also need to promote employee wellness
- Create a mechanism similar to the Federal Employees Health Benefit Plan to offer private insurance packages to buyers, and appoint an independent health board to define essential healthcare services
- Coordinate patient care across people, functions, activities, sites, and time to increase value. This requires that information systems and process improvement techniques be put into place. This would help realign the health system toward improving health rather than just treating disease
- To further achieve value, a system needs to be developed based upon the needs and preferences of patients, provide measurable outcomes, and provide for safety and service. It is important to publicly display outcomes, patient satisfaction scores, and costs as a whole
- The payment system need to be designed to provide patients with no less than the care they need and no more than fully informed cost conscious patients would want. Create payment systems that provide incentives for colleagues to be able to coordinate care for patients and help support informed patient decision making
- Develop and test models of payment based on chronic care coordination, and shared decision making