The Washington Post
examines the Mayo Clinic, a large Minnesota group practice in which physicians are on salary, which has won praise for delivering high quality and low cost care, to see if it is a possible model for health reform: "The Mayo Clinic looms out of the prairie here like the mecca it has become, a world-renowned medical complex that is often cited by President Obama. ... Few dispute the prowess of Mayo, which brings in $9 billion in revenue a year and hosts 250 surgeries a day. But a battle is underway among health-care experts and lawmakers over whether its success can be so easily replicated. Before embracing a fundamentally new approach to health care, dissenting experts and lawmakers say, Congress should scrutinize the assumption that a Mayo-type model is the answer."
"They point out that Mayo's patients are wealthier, healthier and less racially diverse than those elsewhere in the country. It has few poor patients. It limits the number of procedures it performs per patient, but the rates it charges private insurers and self-paying patients is higher than average, allowing it to thrive despite the lower Medicare spending cited by its supporters. Armed with their new stature, officials from Mayo and a handful of similar facilities have become determined lobbyists in their own right. They are pushing for an overhaul of Medicare that would reward cost-effective hospitals and doctors, while punishing others. But if the Mayo model is, in fact, difficult for even the most dutiful hospitals elsewhere to mimic, such an overhaul could set up many providers nationwide for failure -- and a big loss of funds" (MacGillis and Stein, 9/20).