How inexpensive is the Mayo Clinic (and Pervasive Fear of Financial Ruin from Medical Costs)

Dennis Cortese, CEO of Mayo Clinic, has been making the rounds talking about the cost-effectiveness of the Mayo Clinic model.  He has a Perspective piece to be published in NEJM next week.   The Mayo model has a lot going for it, including
            - Salaried physicians
            - Integrated systems, including full electronic medical records
            - Multidisciplinary teams of clinicians
            - Impressive evidence from the Dartmouth Atlas of cost-effectiveness of care
            - Excellent quality numbers
            - Excellent reputation
 I'm personally convinced that multispecialty group practice can provide excellent care and excellent value. 

- Population of Olmstead County, MN is overwhelmingly white and relative prosperous
- Mayo charges additional fees to Medicare beneficiaries coming from outside of its area.  This is important because it means the Dartmouth data understates full cost of care.  It’s also important because it means that patients in poverty are highly unlikely to travel to Rochester for care.  The well-off have impressive social support networks and other resources – and honestly cost less to care for.

Here's a link to a past blog on some of the potential flaws of using Medicare claims data to infer total cost-effectiveness 

Mayo offers great care – and its teams of physicians are known for their quality and innovation.   It’s pretty likely that Mayo offers good value.  It’s just not as inexpensive as it might appear.

The Washington Post today ran a frightening article about how the uncertainty of health care coverage hovers over the middle class in Gaithersburg, MD.  The health care debate in Washington can appear sterile and clinical –but you don’t have to probe deeply to discover pervasive fear of financial ruin associated with medical care in America.