Mayo Clinic warms to health care reform proposal

By Jill Burcum

Last update: July 23, 2009 - 12:54 PM

Mayo Clinic has apparently warmed to the health care reforms proposed in Washington, D.C.

The well-known Rochester clinic merited several shout-outs in President Obama's health care pitch to the nation Wednesday night. And while Mayo had reacted coolly last week to the U.S. House health care bill, Obama suggested that there has been a rapprochement of sorts.

That appears to be the case. Last week, Mayo officials released a statement saying the reform bill wasn't "patient-focused" or "results-oriented," and that the "real losers will be the citizens of the United States." On Tuesday, Mayo officials, while still having significant reservations, said in a new statement that they are looking forward to working with the White House on "bold concepts."

What changed? Over the past week, a policy proposal that Mayo has long pushed for -- a federal health board independent of Congress -- evidently gained traction. It's dubbed the Independent Medicare Advisory Board. Peter Orszag, director of the Office of Management and Budget, described it this way on his blog:

"The Independent Medicare Advisory Council (IMAC) would be an independent, non-partisan body of doctors and other health experts, appointed by the President, confirmed by the Senate, and serving for five-year terms. The IMAC would issue recommendations as long as their implementation would not result in any increase in the aggregate level of net expenditures under the Medicare program; and either would improve the quality of medical care received by the program’s beneficiaries or improve Medicare’s efficiency."

Why is this such a deal sweetener for Mayo? The reason is that clinic officials view such a board as the key to Medicare payment reform. That is, rewarding providers who deliver quality affordable care instead of those that simply do the most procedures. It's thought that if Medicare adopts this type of payment system, it would pave the way for private insurers to do the same.

That would benefit Mayo and many other Minnesota providers who already provide quality care at an affordable cost. Many health care reform experts believe that payment reform emphasizing quality and not quantity is the key to rooting out health care waste and controlling the nation's skyrocketing medical costs.

Still, the IMAC board is a controversial idea. Politicians from states with where Medicare spends far more per enrollee would fight this proposal. It would take away an advantage, albeit an unfair one, that lines the pockets of their health care provider constituents. That's a key reason payment reforms advocates such as Mayo want a board independent of Congress: to take isolate decisions like this from politicians and legions of lobbyists.

The Obama administration has apparently put its support for a board like IMAC in a letter to Congressional leaders. The board proposal is one of the most interesting developments - from a Minnesota perspective - in the national health care reform debate so far. It needs a thorough public airing. But the new focus on it is a welcome sign that policymakers are serious about payment reform and are looking hard at creative ways to make it happen.

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