1. Cleveland Clinic pushes into future

As he walks the halls of the Cleveland Clinic, Dr. Steven Nissen makes the next generation of health care in America sound quite simple.  "Everything that we do is done with the patient at the center of the picture, not the doctor at the center," Nissen says as he takes a visitor on a tour of the clinic's world-renowned cardiac center.  The clinic is consistently among the country's best in quality ratings, and its costs are among the lowest -- which is why President Obama often cites the Cleveland Clinic as an example of how health care in America should be, and why Nissen and other leading doctors here are frequently consulted by lawmakers and administration officials pushing major reforms this year.  Nissen says the clinic's organizational structure -- and its pay structure -- are what make it different.  The traditional model is for the nonsurgeons and surgeons to be organized in separate groups --- imagine a Department of Medicine and a Department of Surgery. The cardiologist works in the former, the cardiac surgeon in the latter.  Add in a financial model where doctors are paid on a "fee-for-service" basis.  At the Cleveland Clinic, Nissen and other doctors are paid a fixed salary.  As a result, Nissen says cardiologists and surgeons share notes and ideas -- and work together to give the patient the best care -- and to emphasize choices that help prevent major procedures and surgeries.  So far, CEO Dr. Toby Cosgrove says the staff has lost a combined 75,000 pounds -- an emphasis on wellness that he says will without a doubt lower the hospital's own health care costs.

CNN by John King June 19, 2009

2. Why Walgreens is building its own universal health-care system

Walgreens, the $59 billion drugstore giant, is building its own universal health-care system, with more than 700 retail and corporate clinics.  As government health policy lurches from a debate to something resembling a plan, Walgreens has assembled the country's most ambitious network of corporate and retail clinics and pharmacies, creating a microcosm of what health care could eventually become in America.  "Whatever does or doesn't happen is good for us," says Hal Rosenbluth, president of Walgreens Health and Wellness, about the Obama administration's reform initiative. If reforms are adopted, says his colleague Peter Miller, as the duo sit together in Rosenbluth's large, well-appointed office in suburban Philadelphia, "they're going to need providers. We're a provider." And if a new health-care law doesn't pass? "There will be more people in need," Rosenbluth says, "and we're affordable, even when paying cash."  Rosenbluth, 57, is an unlikely savior for the American health-care system.  The duo formed Take Care Health Systems in 2005, setting up convenient-care clinics inside drugstores. Two years later, when they had about 50 clinics, they sold Take Care to Walgreens. Since then, they've expanded to more than 350 retail clinics in 35 markets. In March 2008, Rosenbluth and Miller also acquired two leading managers of workplace-based health centers, including the one at L-3, giving Walgreens more than 700 clinics.

Fast Company by Zachary Wilson July 1, 2009

3. Cleveland Clinic executives David Strand and Dr. Bridget Duffy are leaving for California

The Cleveland Clinic confirmed late Tuesday that two of its top executives will be leaving the health system.  Clinic spokeswoman Eileen Sheil said Chief Operating Officer David Strand and Chief Experience Officer Dr. Bridget Duffy had decided "that they wanted to move on, move back home to California."  Strand and Duffy, who are married to each other, declined to comment when reached at home. Strand did not return a late e-mail. The two have been at the Clinic since July 2007.  Strand led day-to-day operations at the Clinic's main campus and managed business units in Northeast Ohio and Florida. The Clinic has expanded globally in the past two years, developing partnerships in new operations in Las Vegas; Abu Dhabi, United Arab Emirates; and Vienna, Austria. It is also cultivating work with biomedical companies in countries from Ireland to Israel and stepping outside the traditional hospital arena to open wellness institutes and run retail clinics in regional CVS/pharmacy stores.  Before joining the Clinic, Strand was chief executive of Life Masters Supported Self Care Inc., a provider of disease management services in San Francisco.  Duffy, who is a native San Francisco, was charged with improving the patient experience at the health system. In the past two years, the Clinic has changed its charity care guidelines, causing community advocates to note that the health system has become more welcoming.

The Plain Dealer by Sarah J. Tribble June 30, 2009

4. Fairview, Medica make a deal to cut costs

The new contract could change how health care is meted out and save millions.  Fairview Health Services could receive tens of millions of dollars if it manages to control costs and hit certain quality measures, under a new three-year contract with Medica, the two organizations announced Thursday.  Officials say the contract represents a dramatic change in how health care is paid for, and will encourage clinics to experiment with less costly types of patient care, such as nurse-only visits and group appointments.  The contract with Fairview will shift the emphasis away from paying doctors for seeing patients and running tests, and more toward practices that result in healthy outcomes, said Mark Eustis, Fairview's CEO. "We can redesign care to be more efficient and effective," he said, by changing the financial incentives. "The cost of care, we believe, will go down because you're not doing unnecessary stuff."

StarTribune by Maura Lerner July 23, 2009

5. Leaders of 2 Dakotas hospitals discuss merger

Officials of the two largest hospitals in the Dakotas say their merger should give them leverage to handle major changes in the nation's health care system.  The merger of the Fargo-based MeritCare and Sanford Health, based in Sioux Falls, S.D., is expected to be completed by next year, officials said Friday. The two groups signed a letter of intent Thursday. The new organization would be called Sanford MeritCare Health System and would be incorporated in North Dakota. It would create a network serving about 2 million people in North Dakota, South Dakota, Minnesota, Nebraska and Iowa. Sanford Health CEO Kelly Krabbenhoft, who is to become the new system's top executive, said he expects the merger to increase revenue, medical services and jobs. The two hospitals currently have a combined $700 million in cash reserves, he said. Some Fargo citizens have complained that the two companies are moving too quickly. Gilbertson said discussions have been ongoing for four months and were easier because the two hospitals have so much in common.

Examiner by Dave Kolpack July 17, 2009

6. President Barack Obama’s Cleveland Clinic visit highlights role model of health care 

President Barack Obama is visiting the Cleveland Clinic today because he considers it a role model in making patient care a priority, he said during a news conference Wednesday night, but he does not expect the Clinic to endorse his proposal to expand health care.  His choice of the Clinic for a short visit underscores the complicated task of selling his health-care reform plan.  It allows him to highlight an influential medical institution that has already achieved technological advancements and cost savings that Obama says his health plan will foster elsewhere.  At the same time, though, his appearance there reinforces that the Clinic -- like many other prominent hospitals -- has not embraced some elements of the plan, most notably a proposal to offer Americans an option to purchase health insurance through the government.  Obama's Clinic visit includes a private meeting with the Chief Executive and President Delos "Toby" Cosgrove and top doctors and precedes a town-hall style forum on health care in Shaker Heights.  The president has been a fan of the Clinic, holding it and the Mayo Clinic in Minnesota up to members of Congress as examples of providing "the highest quality care at costs well below the national norm."  Working off that praise, the Clinic can be expected to highlight its own integrated model of care, which includes employing its doctors and keeping tight controls over procedures performed.  The Mayo Clinic also employs its doctors but came out against the administration's reform efforts last week, posting on its blog that "the proposals under discussion are not patient focused or results oriented."  The Clinic's Cosgrove has not publicly rejected Obama's health-care efforts. And he did not join nearly 20 other health-care leaders this week in crafting an open letter to Congress urging that reform efforts reward quality, not quantity, of care.  Yet Cosgrove has not signaled support for Obama's plan.

Cleveland by Mark Naymik and Sarah J. Tribble July 22, 2009

Tags: Cleveland Clinic, Fairview, Industry News & Competitive Intelligence, Medica, MertiCare, Retail Clinics, Sanford Health