Six leading U.S. providers to share data to improve care, lower costs

Six of the nation's leading healthcare systems—Cleveland Clinic, Dartmouth-Hitchcock, Denver Health, Geisinger Health System, Intermountain Healthcare and Mayo Clinic will join the Dartmouth Institute for Health Policy and Clinical Practice in a collaboration to improve healthcare quality while reducing costs.

The six healthcare systems, with a combined patient population of more than 10 million people, will share data on outcomes, quality and costs across a range of common and costly conditions and treatments. The group will determine best practices for delivering care for these conditions and will disseminate actionable recommendations to providers and health systems across the U.S.

The Dartmouth Institute will coordinate data sharing and analysis, and report results back to the collaborative members to inform development of best practices.

In addition to achieving better quality and outcomes, the collaborative intends to improve the efficiency of standard clinical care delivery to reduce the per capita cost in these conditions and to keep costs in pace with the consumer price index.

Initially, the collaborative will focus on eight conditions and treatments for which costs have been increasing rapidly in recent years: diabetes, heart failure, knee replacement, asthma, weight loss surgery, labor and delivery, spine surgery and depression.

There are wide variations in quality and outcomes for these conditions across the U.S., and together they amount to hundreds of billions of dollars in direct medical costs annually.

The collaborative will share data on outcomes and clinical protocols for the selected conditions and treatments to arrive at optimal care models which can then be implemented by many other healthcare systems. The collaborative aims to see these best practices replicated across the U.S.

The collaborative will first analyze total knee replacement, a procedure that is performed more than 300,000 times a year in the U.S., with a cost that ranges on average from $16,000 to $24,000 per surgery. Simultaneously, the collaborative partners will build the metrics to study the care of the other selected conditions at their centers and arrive at best practices.

Work to define best practices in diabetes and heart failure care will begin early in 2011.

"If we know that the treatment path for diabetes at one institution results in better clinical outcomes, higher patient satisfaction, and lower overall costs, then there is knowledge to be shared and replicated in other institutions," said Robert E. Nesse, MD, CEO of Mayo Clinic Health System and member of Mayo Clinic's Board of Trustees. "We need to learn from each other and put systems in place that ensure that every patient gets the very best, most appropriate care, every time."

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