2008 Symposium

Making Reform a Reality

Denis Cortese, M.D., thanked participants for their hard work over the past two days, and their commitment to creating a health care system that provides all Americans with good outcomes; safe, coordinated care; and great service at a reasonable cost.

He reviewed the Mayo Clinic Health Policy Center's four cornerstones – insurance for all, coordinated care, value and payment reform – as the foundation to create a true system of health care in America. Dr. Cortese also noted than an informal review of 27 publicly available documents showed that many other reform proposals incorporate similar concepts.

"The message is clear," he said. "There is common ground – at the macro level – about these elements of a common vision."

Then, Dr. Cortese reviewed the top priorities that participants as a whole identified for the private sector and the government sector.

Private sector action steps:

• Payment Reform
  Make the case for payment reform with properly aligned incentives (outcomes, prevention, wellness, "virtual" appointments, etc.).
• Universal Clinical IT
  Universal use of interoperable electronic clinical information technology systems (systems that can share information).
• High-Cost Service Program
  Develop care programs for high-impact/high-cost services (end-of-life care, chronic diseases, etc.)
• Coordinating Care Team
  Incent delivery model which provides defined care coordinator for chronic and acute conditions (i.e. medical home).
• Benefits to Improve Health
  Define a minimum standard benefit package that realigns the health system toward improving health in addition to treating disease.

Government sector action steps:

• Insurance For All
  Ensure/mandate insurance coverage for all.
• Interoperable EMR
  Require all providers to have interoperable electronic medical records within a certain time (4-5 years) with patient accessibility.
• Pay For Value
  Direct Medicare to pay for value/outcomes/prevention using innovative payment models.
• Federal Health Reserve
  Implement an independent "Federal Health Reserve Board" to set rules/standards to promote value in health care.
• Care Coordination
  Reward care coordination (whether provided by primary care, specialist or other caregiver).

Dr. Cortese noted several steps that the Mayo Clinic Health Policy Center will take to advance these cornerstones and the solutions developed at this symposium:

• Convene summits of information technology vendors.
• Host a medical education conference in April 2009. Explore ways to train health care professionals to work as teams to improve the quality and efficiency of patient care.
• Consider gathering "a group of groups" with reform proposals to discuss common ground.
• Create cross-sector work groups to implement symposium recommendations for the private and public sectors.

Dr. Cortese again thanked participants and said that the Mayo Clinic Health Policy Center plans to share symposium recommendations with participants, Congress, the new president and other interested parties.