The health systems say they will focus initially on eight conditions and treatments, for which costs have been increasing but for which there is enormous variability in quality and outcomes nationwide. They are knee replacement surgery, diabetes, heart failure, asthma, weight loss surgery, labor and delivery, spine surgery and depression. These conditions, according to a Dartmouth statement, amount to "billions of dollars in direct medical costs each year."
For example, for total knee replacement, a procedure done 300,000 times a year nationally, the cost ranges from $16,000 to $24,000 per surgery. In a statement, the organizations said they will develop metrics to study the care of other selected conditions and determine best practices. The heart failure and diabetes projects will begin early next year.
Added Robert Nesse, CEO of the Mayo Clinic Health System and a 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."