Obama administration points to Cleveland Clinic as reform model

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At the Cleveland Clinic, clinicians deliver care, and yet somehow manage to do it at far-lower prices than many other hospitals. According to the Dartmouth Atlas of Health Care, Cleveland Clinic treats chronically ill patients for $55,000 in the last two years of their life, far undercutting many high-profile academic medical centers. Other famous multispecialty clinics, such as the Mayo, have enjoyed similar success in keeping quality high and prices relatively low.

In a recent letter to Sens. Edward Kennedy (D-MA) and Max Baucus (D-MT), President Obama suggested that the two should look more deeply into why these institutions can pull off such a trick. Unfortunately, the truth is that it's extremely difficult to reproduce the culture and tight teamwork enjoyed by these institutions, policymakers say.

While clinics like the Mayo and Cleveland have a team of employed physicians that work together, improving their ability to coordinate care and roll out evidence-based treatments, typical community hospitals work with independent community doctors running their own separate businesses. While a Mayo, say, might roll out an EMR because it suits the clinic's business interests, independent practices allied with community hospital X might disagree as to whether it makes sense for their practice to get on board.

Meanwhile, current fee-for-service payments do little to encourage hospitals and doctors to come together as the clinic-model teams have. Maybe pushing for those incentives should be next on President Obama's list.

To learn more about this issue:
- read this Wall Street Journal piece