Political Party

Mayo Clinic scores major political victory

Mayo Clinic got a boost of good news Tuesday on its efforts to shape health care reform.

The Senate Finance Committee accepted an amendment to its health care bill that would set up a "value index" aimed at paying providers based on quality of care, not quantity. That is something that Mayo Clinic has aggressively been lobbying for as lawmakers have worked to draft legislation. Here is a link to a story in today's paper by PB Health Reporter Jeff Hansel.

Minnesota DFL Sen. Amy Klobuchar has been pushing hard to get the language included in the bill. Last week, she and the amendment's author Sen. Maria Cantwell, D-Washington, led a group of 28 senators in calling on the president to change the payment system.

In a news release, Klobuchar is quoted as saying, "The change included today will help control costs and get the most from our health care dollars. This will strengthen the strong safety net of Medicare by ensuring funds are there to pay for our seniors' health care."

Dr. Denis Cortese, the clinic's president and CEO, praised the lawmakers' efforts saying that "paying for value in health care is one of the four cornerstones for reform that emerged from our consensus driven health policy process."

Of course, the tricky part is figuring out exactly how to measure quality. Cortese said it needs to include outcomes, safety and patient satisfaction. Under the proposal in the senate bill, it would require a "value index" to established that would go into effect in 2012 and be administered by the secretary of Health and Human Services. But other than that, the details are sketchy.

Last week,  American Medical Association President Dr. J. James Rohack said that while the organization is open to this type of payment system, he said it needs to be tested before it is applied to everyone. He also warned it is important for physicians to not be penalized for patients who make poor choices. For example, if a patient is prescribed a cholesterol-reducing drug and opts not to take the medication and eats a double cheeseburger, it is unfair for the doctor to be held responsible for that patient's poor health outcome.

Mayo Clinic gets a national exam and Kline's attacks draw cheers

There's plenty of health care reform-related news to catch up on from the past weekend.

Mayo Clinic is scrutinized in a Washington Post article entitled "Is the Mayo Clinic a Model or a Mirage? Jury is Still Out." The article raises the question of whether the Mayo model can be replicated at other hospitals, given that the clinic's patients are generally wealthier, healthier and less racially diverse than in other parts of the country. It's an interesting read.

Also, Second District Rep. John Kline held a health care town hall on Friday. The Pioneer Press reports that the Republican congressman attacked the Democrats' health care overhaul plans. He even went so far as to shove a phonebook-size binder said to be the Democrats health plan off a table to the floor. According to the story, the crowd reacting by going "wild, rising to deliver cheers and extended applause."

Pawlenty: Proposed tax puts genomics partnership 'in jeopardy'

Gov. Tim Pawlenty sent a letter today to Sen. Amy Klobuchar and Sen. Al Franken expressing his opposition to a $40 billion tax on the medical device industry that is party of the Senate Finance Committee's health care reform proposal.

In the letter, the Republican governor warns that the tax could harm The Minnesota Partnership for Biotechnology and Medical Genomics, a partnership between Mayo Clinic and the University of Minnesota. The state provided upwards of $80 million in direct and leveraged funding for the partnership since it was announced in 2003, according to Mayo Clinic Spokesman Bob Nellis.

Pawlenty writes, "During the past 6 years, the University of Minnesota and the Mayo Clinic have initiated a bioscience initiative backed by tens of millions of state dollars. The more than 1,400 expected jobs involved in this effort and Minnesota's leadership in this area are now in jeopardy."

Asked whether Mayo Clinic opposes this tax provision, Nellis said the clinic does not have a position on the proposed tax.

Nellis added that the 1,400 job estimate cited by Pawlenty is for jobs created directly or indirectly by the partnership over the next 10 to 20 years.

In the letter, Pawlenty also argues the tax would hurt the state's medical device makers including Medtronic, Boston Scientific, 3M and St. Jude. He adds that the tax would not only apply for pacemakers and heart valves but also 80,000 other products including wheelchairs, thermometers and diagnostic imaging equipment. You can click the link below to read the letter.

Download 09.14.09 Gov. Pawlenty letter to Sens. Klobuchar & Franken

Mayo's Korsmo weighs in on Obama's speech

Among those sitting in the gallery last night listening to President Obama's address was Mayo Clinic's Jeff Korsmo — executive director of the clinic's Health Policy Center.

Korsmo voiced strong support for Obama's efforts to overhaul the health care system saying the status quo is not sustainable.

"Overall, we support his call for health care reform. I think he showed good leadership on the issue. I think he did a good job on calling on both parties to pass meaningful reform," he said.

The clinic also posted a statement in support of the president on the center's blog. Korsmo did note that Obama did not offer many details on his ideas for reforming the payment system. Mayo has been pushing hard to change how Medicare providers are reimbursed to make sure that it favors quality of care, not quantity of care.

"We won't really change the way we deliver health care unless we change the way we pay for it," he said.

The Mayo Clinic is also opposed to a public health insurance option similar to Medicare. But Korsmo did say Obama seemed to be open to other ideas.

The clinic is a fan of several of the proposals Obama mentioned. That includes the individual mandate requiring people to buy insurance and the effort to prohibit insurance companies from denying coverage to people with pre-existing conditions. For more on Mayo's position on health care reform, go here.

Congressional delegation urges changes to Medicare system

The entire Minnesota Congressional delegation sent a letter to President Obama today urging him to address inequities in Medicare payments and reward states like Minnesota that provide quality care at a lower cost than other states.

According to a press release from DFL Congresswoman Betty McCollum, of St. Paul, she helped get all members of the delegation from both sides of the aisle to sign on to the letter. The letter also voices opposition to a public plan that would be based on the current Medicare reimbursement system. The letter states that "any public insurance option that is based on Medicare's current reimbursement formula would only further penalize Minnesota and undermine the very success our state has attained in delivering efficient, quality care."

Mayo Clinic has long voiced concern about the current Medicare system arguing it fails to take quality into account. Here is a link to the letter.

Demmer not convinced of need for Rochester rail bypass

Hayfield Rep. Randy Demmer may not be on board with a plan backed by Mayo Clinic for a railroad bypass that would run south of Rochester.

The bypass would allow Canadian Pacific Railway train traffic to be re-rerouted south of the city. Backers of a proposed high-speed passenger rail line have said this route could also one day connect Rochester to Chicago and the Twin Cities. But the main purpose for the bypass is freight traffic. Mayo Clinic has long been opposed to seeing increased freight traffic come through the city arguing it would be a safety hazard.

But that proposed rail line would run through a good chunk of Demmer's district in Dodge County. The Republican said he has concerns with the proposal.

"I just don't know that I am convinced yet that this is a high enough need to cut through some of the best farm country in the nation," Demmer said.

The 48-mile rail line would start in Dover and end up near Dodge Center.

He said he is also concerned about the project's $325 million price tag and questions whether that is the best use for that money. Still, he said he is trying to keep an open mind. He has already been fielding phone calls from constituents upset about the possible bypass.

Ultimately, Demmer said it is important supporters of the bypass put together public information meetings where residents can see detailed maps and learn how the proposed route could affect them. Supporters also need to be open to hearing the concerns and suggestions of landowners.

"There needs to be that kind of dialogue," he said.

Pawlenty, Klobuchar, Walz back proposed Roch rail route

According to a press release issued this morning, Gov. Tim Pawlenty, U.S. Sen. Amy Klobuchar and U.S. Rep. Tim Walz all back a proposed rail corridor that would run south of Rochester. It would primarly be used for freight but could also accomodate high-speed rail  Here is the press release:

(Rochester, MN) - Congressman Tim Walz, Senator Amy Klobuchar, and Governor Tim Pawlenty today announced their support for a southern rail corridor around Rochester's south side. The southern rail corridor would route trains away from downtown Rochester and the Mayo Clinic to reduce safety risks and allow for future development. The project would create hundreds of jobs during the construction phase while potentially preserving thousands of Mayo Clinic jobs.

Last week in Washington, Rep. Walz, Sen. Klobuchar and Gov. Pawlenty met with Mayo Officials to discuss the four funding options for the corridor, which could include (1) funding through the Surface Transportation Bill reauthorization; (2) funding through a loan application by the State of Minnesota to the Federal Railroad Administration; (3) funding obtained by applying for American Recovery and Reinvestment Act dollars from the federal Department of Transportation; and (4) state share of bonding dollars to leverage federal funds.

Congressman Walz, a member of the U.S. House Transportation and Infrastructure Committee, agreed to request the southern rail corridor in this year's reauthorization of the federal Surface Transportation Bill after hearing from the Mayo Clinic that the Clinic's Board of Trustees continues to have serious concerns about the economic and patient safety challenges the CP rail line presents to the Mayo's Rochester campus.

"I will do everything in my power to preserve and protect the heart and soul of Mayo Clinic in southern Minnesota and to ensure that Mayo can continue to grow here in our state," said Congressman Walz. "Mayo's world-renowned medical breakthroughs are a direct result of the high caliber of its Minnesota employees and the supportive community in which the Clinic resides. Any significant threat to Mayo's ability to innovate and provide good-paying jobs is at odds with the development of lifesaving medical techniques and quality of life for all Minnesotans."

Walz went on to state that he would be requesting the southern Minnesota rail corridor as a High Priority Project of national significance in the 2009 reauthorization of the Surface Transportation Bill but also planned to assist with efforts to obtain funding from one or more of the other available funding streams.

Senator Klobuchar will pursue federal support for the corridor. "This is good for the Mayo clinic and good for the residents of Rochester," Senator Klobuchar said. "As a world leader in medical breakthroughs and patient care, the Mayo Clinic has not only been an economic engine for Minnesota, but an active and engaged community member in Minnesota's third largest city. I will continue to fight for federal support to keep the patients of Mayo and people of Rochester safe."

Governor Tim Pawlenty is directing the Minnesota Department of Transportation to apply for federal grants that could be utilized for the bypass. The Governor also said he would support state bonding funds in future years that could leverage federal funds.

"The State of Minnesota has been a significant partner with the Mayo Clinic over the years and Mayo has repaid us back many times over with their contributions to our state and the world," Governor Pawlenty said. "We need to take all reasonable steps to ensure that Mayo continues to grow and thrive in Minnesota."

The southern rail corridor would be built in a way that primarily supports freight but also accommodates high speed passenger rail if data from the Minnesota Department of Transportation rail study supports a high speed rail route from Chicago through Winona into Rochester. The rail corridor would move existing CP track to the south of Rochester to mitigate safety concerns around the highly populated downtown Rochester area, which includes the Mayo Clinic campus. The rail corridor project is expected to create just less than 50 miles of new track outside of the City of Rochester, allowing for higher train speeds and quicker shipping of commodities for local farmers.

Roch officials work on hush hush high-speed rail route

Fellow Post-Bulletin reporter Jeff Pieters has a story today about Rochester area officials holding confidential talks to map out a potential high-speed rail route. Jeff reports that Mayo Clinic, Rochester and Olmsted County have been holding "low-profile meetings" with rural officials in Olmsted and Dodge counties to build support for the plan.

While the official plan is not being released, those who have seen it say it would run from Winona County along the current Dakota, Minnesota & Eastern Railroad. At Dover, it would head southwest to Interstate-90 leading to the Rochester International Airport. From there, it would travel through Dodge County to Owatonna and then north along Interstate 35 to the Twin Cities.

The question becomes can Mayo and Rochester officials win support for this idea after having fought the DM&E upgrade that would have brought more coal trains in to the city. This route seems to mimic a bypass Mayo Clinic had supported for these coal trains. Jeff talks to some rural officials in a second story to gauge their interest.

Hospital leaders speak out against cuts

Hospital leaders from across the state traveled to the Capitol this morning to speak out against Gov. Tim Pawlenty's proposed cuts to hospitals. Among those making the trek were Mayo Clinic lobbyist Frank Iossi. He said Mayo Health Care Systems would lose an estimated $46 million in reimbursements over the next two years for the state.

Iossi said right now half of Mayo Health System's patients are on Medicare, Medicaid and MinnesotaCare. A major problem is that reimbursements have lagged behind actual costs for treatment. For instance, Mayo Clinic gets reimbursed 68 cents for every $1 spent on a Medicare patient.

"It's a cost shift. We have to charge others more for that, and we're at the point where we can't do that anymore," he said.

Statewide, the Minnesota Hospital Association estimates Pawlenty's budget would result in $764 million cuts to hospitals. Meanwhile, the House DFL's budget plan would cut more than $76 million. Here are some of the estimated cuts for Rochester hospitals under the governor's budget plan : St. Marys Hospital, $19 million; Methodist Hospital, $6.4 million; and Olmsted Medical Center, $1.3 million.