Mayo Clinic and its collaborators have been awarded nearly $60 million from the Center for Medicare and Medicaid Innovation (CMMI) to improve health care delivery. The grants will improve critical care for Medicare and Medicaid beneficiaries in intensive care units, improve care and outcomes for patients who have depression and diabetes or cardiovascular disease, and work with patients with chronic conditions and their families to better engage them in medical decisions.
"We're grateful that CMMI has recognized the commitment of our physicians, scientists and collaborators to drive patient-centered, high-value care," says John Noseworthy, M.D., president and CEO of Mayo Clinic. "Our commitment to innovation and patient-centered, high-value care will continue regardless of how the Supreme Court rules on the Affordable Care Act or how health care reform evolves politically. What will remain constant is our unfailing focus on meeting the needs of patients."
The Health Care Innovation Awards fund up to $1 billion in grants to applicants who will implement compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and Children's Health Insurance Program, particularly those with the highest health care needs.
"These grants provide the funding needed to transform the way patients in the United States experience health care," says Veronique Roger, M.D., M.P.H., director of Mayo Clinic's Center for the Science of Health Care Delivery, which rigorously studies, validates and implements innovative health care delivery models. "At the end of the day, health care is about treating patients in a manner that delivers optimal outcomes and quality of life in the most efficient way possible."
Project I: Patient-centric electronic environment for improving acute care performance
Mayo Clinic Lead Investigators: Ognjen Gajic, M.D.; Brian Pickering, M.B., B.Ch.
Geographic Reach: Minnesota, Massachusetts, New York, Oklahoma
Funding Amount: $16,035,264
Estimated Three-Year Savings for Government Programs: $81,345,987
Summary: Mayo Clinic, in collaboration with US Critical Illness and Injury Trials Group and Philips Research North America, is receiving an award to improve critical care performance for Medicare and Medicaid beneficiaries in intensive care units (ICUs). Data show that 27 percent of such Medicare beneficiaries face preventable treatment errors due to information overload among ICU providers. Mayo Clinic's model will enhance effective use of data using a Cloud-based system that combines a centralized data repository with electronic surveillance and quality measurement of care responses. As a result, Mayo expects to reduce ICU complications and costs.
Over a three-year period, Mayo Clinic will train 1,440 existing ICU caregivers in four diverse hospital systems to effectively use new health information technologies to manage ICU patient care.
Mayo Clinic's expertise: Mayo Clinic brings informatics expertise to translate data into actionable clinical knowledge. Other grant-supported Mayo Clinic initiatives that rely heavily on informatics include the Rochester Epidemiology Project, Beacon, Strategic Health IT Advanced Research Projects (SHARP) Program and the Mayo Clinic Center for Translational Science Activities.
Project II: Care management of mental and physical comorbidities: A triple aim bull's-eye
Mayo Clinic Lead Investigator: Mark Williams, M.D.
Geographic Reach: Minnesota, Wisconsin, Iowa, Pennsylvania, California, Michigan, Washington, Colorado, Massachusetts
Funding Amount: $17,999,635
Estimated Three-Year Savings for Government Programs: $27,693,046
Summary: The Institute for Clinical Systems Improvement (ICSI) of Bloomington, Minn., is receiving an award to improve care delivery and outcomes for high-risk adult patients with Medicare or Medicaid coverage who have depression plus diabetes or cardiovascular disease. The program will use care managers and health care teams to assess the conditions' severity, monitor care through a computerized registry, provide relapse prevention, intensify or change treatment as warranted, and transition beneficiaries to self-management.
Over a three-year period, ICSI and its partners will train the approximately 80 care managers needed for this new model.
The partnering care systems include clinics in ICSI, Mayo Clinic Health System, Kaiser Permanente in Colorado and Southern California, Community Health Plan of Washington, Pittsburgh Regional Health Initiative, Michigan Center for Clinical Systems Improvement, and Mount Auburn Cambridge Independent Practice Association, with support from HealthPartners Research Foundation and AIMS (Advancing Integrated Mental Health Solutions).
Mayo Clinic expertise: Mayo Clinic brings expertise in care coordination through successful partnerships with ICSI on the DIAMOND project for management of depression. Results are available on the Web at www.mnhealthscores.org; two Mayo primary care sites are leaders in the state. Mayo also has developed an integrated program for behavioral health in primary care.
Project III: Engaging patients through shared decision making: Using patient and family activators to meet the triple aim
Mayo Clinic Lead Investigator: Doug Wood, M.D.
Geographic Reach: California, Colorado, Iowa, Idaho, Massachusetts, Maine, Michigan, Minnesota, New Hampshire, New Jersey, New York, Oregon, Texas, Utah, Vermont, Washington
Funding Amount: $26,172,439
Estimated Three-Year Savings for Government Programs: $63,798,577
Summary: The Dartmouth College Board of Trustees is receiving an award to collaborate with 15 large health care systems around the country — including Mayo Clinic — to hire Patient and Family Activators (PFAs). The PFAs will be trained to engage in shared decision making with patients and their families, focusing on preferences and supplying sensitive care choices.
PFAs may work with patients at a single decision point or over multiple visits for those with chronic conditions. This intervention should lead to reduced utilization and costs, and provide valuable data on patient engagement processes and effective decision making — leading to new outcomes measures for patient and family engagement in shared decision making.
Over a three-year period, the Dartmouth College Board of Trustees-sponsored program will train 5,775 health care workers and create 48 positions for patient and family activators.
Mayo Clinic expertise: This project is part of the High Value Health Care Collaborative (HVHC), of which Mayo Clinic is a founding member. HVHC identifies best practices and subsequently shares them with other health care institutions so that all providers and patients can benefit from this work. The collaborative was founded in 2010 and identified nine high-volume, high-cost, high-variation conditions to focus on, with the goal of improving care and outcomes, reducing variation and lowering costs.