John Noseworthy: The 2% cuts from sequestration affect us in both practice, education and research, all three parts of our mission. It is significant. It is approximately $47.6 million in one year to Mayo Clinic and a little more than half of that is in payments for our physician services in the practice. About $20 million is in research, and about $2 million is in education. And that kind of cut means you have to slow down or prioritize what you can't do and the things that you were doing that were high-priority need to be stopped or slowed down. Ultimately, it means that we can hire fewer people, fewer young people, fewer young scientists, fewer young physicians, so these cuts are very, very painful.
Zigmond: The CMS Innovation Center is responsible for testing many different payment models. Which payment model do you think is showing the greatest promise for success?
Noseworthy: There is a whole variety of them, and there is not going to be one that meets all types of situations. There is a role for bundling; there is a role for shared savings, and perhaps, there is still a role for fee-for-service for the most complex care that really can't be bundled. We are investing in modeling that to understand what is best for our patients.
Zigmond: In January, Mayo announced its collaboration with Optum, the data analytics arm of United Health Group, to launch Optum Labs. This will marry clinical information and new claims data. Where are you in the process, and what are the short-term and long-term goals?
Noseworthy: The short- and long-term goals for Optum Labs are essentially to drive value, understand what works in healthcare, what are the clinical outcomes that we are all driving toward and what are the cost drivers of that. What's the total cost of care, and what aspects of the costs can be reduced or eliminated to reduce the cost while still improving the quality of care, and therefore, improving the value. The promise of Optum Labs will really come to fruition when other great groups, large academic medical practices, research universities, biotech, pharma and device companies, other insurers and health policy groups, all come together and help us use informatics to pull out the data here that will really define value. That's what we want to create. I think the potential is absolutely almost limitless and really should change the way we design healthcare systems in the future.