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Friday, March 21, 2008

Mayo Clinic head says Congress should get out of Medicare

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Congress has politicized and controlled Medicare to such an extent that its payment policies are backward, Dr. Denis Cortese, president and CEO of the Mayo Clinic, told a National Press Club audience Friday.

Medicare, governed by Congress, “pays the most dollars to the regions of the country that provide the worst outcomes, the worst safety, the worst service, and the worst integrated, coordinated care,” Cortese said. “I think that’s backwards.”

Medicare should pay fees based on results, not compliance with process measures, he said.

“Paying for process is not going to guarantee that we’re getting the outcomes. We have got to measure the outcomes,” he said.

“Right now, sometimes the more mistakes we make on patients, the more we make. We don’t make the accurate diagnosis the first time, well we get paid for the next round of tests and things. It’s a little backward from the patients’ viewpoint.

“We ought to be rewarding folks for getting it right the first time.”

Cortese said Medicare has been doing “just the opposite” of paying for value and that Congress “interferes with its ability to do what it needs to do.”

Instead of a Medicare program directed by Congress, Cortese said it should be governed by a quasi-independent agency along a model similar to the Federal Reserve system or the Securities and Exchange Commission.

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