Mayo summit: Healthcare payment reform requires commitment to change

Sustained payment reform must begin with a commitment to change, according to a panel of experts.

PHOENIX—Healthcare payment reforms won't be effective unless hospitals and health systems adopt a “policy of continuous improvement” to ensure that they meet patient needs across the spectrum of care

So said a panel of experts convened by the Mayo Clinic and Arizona State University Alliance for Healthcare.

The panel attended last week's Health Care Payment Reform Summit, and met with the press on Saturday to discuss their findings. The biggest takeaway: There must be a sustained culture change in order for payment reforms to take hold.

George Halvorson
George Halvorson

“Healthcare historically has been a status quo model—improve to a certain point and stay there,” George Halvorson, chair and CEO of the Institute for Intergroup Understanding, told reporters. “The model of the future needs to be better.”

Halvorson said that the industry as a whole must embrace data and computer systems that can make care better and track where improvements are most needed. This extends to payment reform, he said, as a model needs to be established that encourages innovation and consistent improvement.

Elliott Fisher
Elliott Fisher

One particular area of focus is to look at ways to reduce costs and improve care for the most complex patients. Elliott S. Fisher, M.D, director of The Dartmouth Institute for Health Policy and Clinical Practice, said that the top 5% of the sickest patients incur the most costs and use the most healthcare resources. These patients often have needs outside of the hospital's control that can contribute to their situations, like homelessness or food insecurity, he said.

The panelists agreed that an effective solution is for providers to better identify patients with complex conditions and unmet socioeconomic needs. Therefore, Fisher said, it’s important that adequate data is gathered for providers to improve care for patients with complex conditions.

This extends beyond payment reform to other innovations in care delivery, too. Providers should include payers in the discussion and mine the data they have available as well.

“To hell with single payer, we need a single data system,” he said, noting that it is essential to partner with policymakers to address this issue and the future of payment reform.

Lois Krahn
Lois Krahn

Lois Krahn, M.D., a psychiatry professor at the Mayo Clinic College of Medicine, said another way providers can better treat complex patients is to encourage them to clearly define goals for their care and engage in shared decision-making. That connects to payment reform as it will allow providers to better provide only the care that is needed and wanted.

“They can do a better job of delivering the care that you want and need but no more than you want and need,” she said.