Health Care Practice and Policy
The Office of Health Care Practice and Policy conducts research relating to value and quality measurement, risk adjustment, economic analyses, processes of care, and alternative payment models. It provides consultative support to Mayo Clinic's practice, identifying quality, safety and other performance benchmarks and gathering evidence to help continually improve clinical practice.
Results of projects carried out in the Office of Health Care Practice and Policy benefit patients by advancing high-quality, affordable and patient-centric health care and by aligning optimal care delivery models with the changing reimbursement environment.
Health care policy expertise and research informs leadership with respect to national and international issues affecting health and health care delivery. This enables Mayo Clinic to maintain its position at the forefront of the national health policy discussion.
Areas of focus
- Health policy — providing national health policy expertise as a resource across Mayo Clinic
- Impact assessment — assessing how health care policies and care processes affect health care quality, utilization, patient satisfaction and clinical outcomes
- Payment reform — analyzing health insurance reform and impact on access and quality for primary and specialty care
- Benchmarking — comparing outcomes of Mayo Clinic care with other institutions to identify areas of strength and opportunities to improve processes of care
- Comparative effectiveness — identifying and evaluating novel care delivery models
- Big data management — advancing techniques for data linkage and data mining
- Consultative services — offering clinicians and investigators specialized services to conduct analyses on economic costs and health care resource utilization using a variety of health economic methodologies in a variety of disease areas
Health care reimbursement and payment reform initiatives
The Office of Health Care Practice and Policy conducted rigorous analyses by assessing and linking several data sources — such as Centers for Medicare & Medicaid Services claims, Mayo Clinic clinical information, and High Value Healthcare Collaborative data to understand the policy impact of Medicare's Comprehensive Care for Joint Replacement Model final rule on provider organizations, including Mayo Clinic. This work provided an improved understanding of clinical and nonclinical predictors of higher cost to inform health care policy and payment.
Initiatives support the development, testing and impact of innovative health care payment models shifting from a reimbursement system based on the volume of services provided to a system based on the value of care.
Researchers in the Office of Health Care Practice and Policy assess quality and cost metrics with complex care data to identify the types of payment reform that lead to better value. This research informs and positions Mayo Clinic to engage in critical internal and external collaborative payment reform dialogues.
Find related publications.
Collaboration to improve care
OptumLabs is a large data warehouse that was created through collaboration between Mayo Clinic and Optum Inc.
A team of Mayo Clinic researchers are conducting large observational studies using the OptumLabs data asset. The team tests hypotheses, makes discoveries and delivers solutions that improve patient care and value.
Projects in the Mayo Clinic Kern Center for the Science of Health Care Delivery use the OptumLabs data to focus on comparative effectiveness and quality and safety measures. Research contributes to health economics, value and policy analysis and provides information that's useful for delivery system and payment reform initiatives.
Through OptumLabs, Mayo Clinic researchers are analyzing data from more than 150 million patients to find optimal treatments for conditions in a given setting, to understand variations in care and to examine the effectiveness of processes of care. OptumLabs provides a research environment and a translation network to assist in translating knowledge to changes in practice and policy.
Another major initiative is the High Value Healthcare Collaborative (HVHC). Within the HVHC, researchers work together to identify ways to improve quality of care and health outcomes. Their goal is to reduce cost by identifying best-practice care models and by facilitating adoption of those models nationwide. Further, researchers in the HVHC collaboration investigate and support development of new value-based payment models.
Quality and safety
As Mayo Clinic researchers seek to understand the richness of the data resources available in the 21st century, they also find new challenges. Changing policies and systems add to the complexity of the science of health care delivery. Too often, news reports of data compromise create unease and uncertainty. Part of the work in the Office of Health Care Practice and Policy centers on ensuring data quality and patient safety is ever present in the designs of new and evolving systems.
One project showed that adding the last four digits of people's Social Security numbers to administrative medical data can enable trusted repositories to link data with nearly perfect accuracy without compromising patient confidentiality.
Data linkage is a fundamental building block for health information exchange. When patient-level data can be linked within and across health care-related data sources, investigators can address important health care policy issues, including tracking patients across sites, relating interventions at one site to outcomes recorded at another, identifying posthospital outcomes, and distinguishing repeat procedures on a single patient from multiple procedures that are each performed on a different patient.
Read the study abstract.
Value: More than just a good health outcome
In the current health care fiscal environment, measurement of health outcomes alone is no longer sufficient for advancing an institution's ability to demonstrate value. Researchers must also demonstrate that the expected benefits of a new agent, technology or intervention are worth the costs. To do so, they need formal economic evaluations, a group of analytic methods to quantify and compare the benefits — prevented disability, improved quality of life, and so on — and the costs of medical interventions.
Research addressing value in health care requires a measure of cost. The Office of Health Care Practice and Policy used widely accepted costing methodologies to create a service-level, standardized health care cost data warehouse from an institutional perspective that includes all professional and hospital-billed services for Mayo Clinic patients.
The resulting standardized costs in the data warehouse can be used to create detailed, bottom-up analyses of professional and facility costs of procedures, medical conditions and patient care cycles without revealing information that could be sensitive for patients or Mayo Clinic.
Read the study abstract to learn more about the cost data warehouse.