Word: mayo
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Punishing the Mayo Clinic financially for efficiently and effectively providing Medicare services is just one failing of our health-care system. Attempts to lower Medicare costs, even those now under consideration, focus on lower fees--a maneuver well known to increase the number of services, many unneeded, and actually increase total costs. Truly effective care can be delivered only by integrated, cohesive, properly incentivized, Mayo-like multispecialty medical groups with strong leadership and a commitment to quality. Unfortunately, legislation pending in Congress ignores this need. Charles V. Allen, M.D., MODESTO, CALIF...
...lowered the calorie counts on certain items. For example, in March 2007, a Chicken Club sandwich at Wendy's was listed as being 650 calories. In June 2008, as the New York law kicked in, the item was 540 calories - a 17% drop. (Wendy's used a lower-calorie mayo to reduce the count, but a spokesman insists menu-labeling played no part in the move. Call it a happy coincidence.) (See how many calories are in the Taco Bell Chicken Ranch Fully Loaded Taco Salad...
...medicine, the idea would be to reward quality rather than quantity, to give providers incentives to keep us healthy and reduce unnecessary treatments, to encourage doctors and hospitals to promote a culture of low-cost, high-quality care. One reason the Mayo Clinic already provides low-cost, high-quality care is that it keeps its doctors on salary, insulating them from fee-for-service inducements to overserve; unfortunately, Mayo is hemorrhaging cash on its Medicare patients, because the current system penalizes responsibly conservative care. Doctors don't get paid for thinking about a case or returning a phone call...
...Mayo doctors are also shielded from the incentives that discourage evidence-based medicine, because they all receive fixed salaries. They don't make more if they do more to patients, and they don't make less if they take more time to talk to them - even if they use the time to explain why a CT scan or a wonder drug advertised on TV might not be advisable. They don't have to worry about reimbursements that overvalue radiological tests and invasive prostate treatments, undervalue preventive care and watchful waiting and put zero value on returning a phone call...
...That's the bad news about Mayo's success: it's not sustainable. The harsh reality is that smart, conservative, data-driven, patient-focused medicine is not necessarily profitable medicine. Last year, Mayo lost $840 million on $1.7 billion in Medicare work. It compensated by charging private insurers a premium for the Mayo name, but they're starting to balk. "The system pays more money for worse care," says Mayo CEO Denis Cortese. "If it doesn't start paying for value instead of volume, it will destroy the culture of the organizations with the best care. We might have...