Cleveland Clinic praised by President Barack Obama for efficiency, control of costs

Cleveland Clinic praised by President Barack Obama for efficiency, control of costs

Posted by mwhitley June 04, 2009 19:44PM

Gus Chan/The Plain DealerThe Cleveland Clinic has won praise from President Barack Obama for providing "the highest quality care at costs well below the national norm."

The Cleveland Clinic won praise from President Barack Obama twice this week, and hospital leaders are playing a role in the administration's front-burner issue of health-care reform.

Obama, who bench-pressed 260 pounds while working out at the hospital's gym when he was in town during the primaries, referred to the Cleveland Clinic -- as well as the Mayo Clinic in Minnesota -- as examples of hospitals providing "the highest quality care at costs well below the national norm."

"We need to learn from their successes and replicate those best practices across our country," Obama wrote in a letter to Sens. Ted Kennedy and Max Baucus this week.

The president lobbied this week for quick passage of legislation to overhaul the nation's health-care system. Democratic senators, including Ohio's Sherrod Brown, say they expect a comprehensive bill to be written by the end of the summer.

At the center of the health reform debate is a desire to lower costs, which are an increasing burden for families already struggling with the nation's economic downturn: Six in 10 Americans say they or a member of their household have delayed or skipped health care in the past year because of cost, according to an April survey by the nonprofit Kaiser Family Foundation.

The White House staff says that when Obama describes the Clinic, as well as the Mayo Clinic, as low-cost and high-quality, he is referring to statistics in the Dartmouth Atlas of Health Care 2008, a report from the Dartmouth Institute for Health Policy and Clinical Policy, a research and educational institution in New Hampshire.

The study tracks Medicare spending on similar chronically ill patients during the last two years of their lives. And the numbers show that hospitals that are more efficient and make fewer mistakes end up costing less -- even if the procedure's price tag is higher than at other hospitals.

"They are half the overall costs of other institutions across the country," said Dr. Elliott Fisher, the institute's director for population health and policy. "It's a very impressive model, and we have lots to learn."

The average number of days spent in the hospital by a Medicare patient in the last two years of life was 21.3 at Mayo and 23.9 at the Cleveland Clinic. By comparison, the average number of days at the University of California, Los Angeles Medical Center was 31.3.

Even more, while the Cleveland Clinic spent $1,307 a day on a patient, UCLA spent $1,871 a day.

"The Cleveland Clinic is more efficient," said Maggie Mahar, health-care fellow at the Washington-based Century Foundation. "You're likely to spend fewer days in the hospitals, see fewer specialists, and the total final bill will be less."

A key to the low costs, Mahar said, is the fact that the physicians are employed by the hospitals. Physicians who work for a single employer usually find it easier to coordinate care, repeat tests less and provide a continuum of care. In contrast, physicians who have rights at several hospitals can find it more challenging to coordinate care and track patients' progress, Mahar said.

"They have no reason to do more," she said. "At Mayo and the Cleveland Clinic, they tend to get the diagnosis right the first time."

Oliver "Pudge" Henkel, the Clinic's chief external-affairs officer, said he has been on the phone with White House staff members and federal lawmakers discussing how the nation's health-care system should be shaped.

"The health-care provider has to share responsibility with a patient in helping the patient pursue healthier lifestyles," Henkel said.

source: http://www.cleveland.com/medical/index.ssf/2009/06/cleveland_clinic_praised_by_pr.html