The U.S. leads the pack in the percentage of older adults who have trouble paying their medical bills.
Jan. 16--Until a few years ago, the world-famous Mayo Clinic wasn't even an "in-network" option for people with insurance from UnitedHealth Group.
But now, amid more examples of collaboration between insurers and health care providers across the country, Mayo Clinic and UnitedHealth have decided to jointly open a research lab in Massachusetts that will analyze how to get more value from health care spending.
Both companies are Minnesota health care heavyweights employing thousands: Mayo is based in Rochester, and UnitedHealth is in Minnetonka.
Called Optum Labs after UnitedHealth's data unit, the research effort is aimed at finding the most efficient and effective treatment and diagnostic approaches for a broad range of conditions from leukemia to hepatitis C.
The research lab is near the Massachusetts Institute of Technology in Cambridge. That setting is "ideal" because of the large volume of other medical research work in the Boston area, said Jeffrey Smith, a spokesman for Optum.
The lab will employ 50 to 60 people who will bring together claims data from UnitedHealth -- one of the nation's largest health insurers -- with Mayo Clinic's research on patient outcomes. By combining the data sets, researchers hope to identify the most cost-effective ways to care for patients.
Neither UnitedHealth nor Mayo Clinic would say how much they are spending on the effort, but the plans caught the attention of Minnesota Gov. Mark Dayton.
"This partnership between two
of Minnesota's health care superstars ... will lead to better and more cost-effective medical decisions, benefiting both patients and payers," Dayton said in a statement.
One barrier to doing such research, officials said, has been that patient information tended to be gathered in two distinct areas -- the claims data collected by health insurers and the clinical data stored by doctors and hospitals. The new research center will bring together those two data sets so that doctors can better understand the total cost of care for patients, said Dr. John Noseworthy, the chief executive officer of Mayo Clinic.
"We believe that patients should expect more out of U.S. health care -- both higher quality, but also affordability," Noseworthy said. "This strategic research alliance allows us, for the first time, to truly examine best outcomes for patients at lower cost."
UnitedHealth Group is one of the country's largest health insurers, with $5.1 billion in net earnings during 2011 on $101.9 billion in revenue. The company's Optum unit, based in Eden Prairie, sells technology-based services to doctors, hospitals and health insurers.
The nonprofit Mayo Clinic operates hospitals and clinics in Arizona, Florida, Iowa, Minnesota and Wisconsin. In 2011, the clinic posted operating income of $610 million on $8.48 billion in revenue.
Mayo Clinic employs more than 34,000 people in Minnesota. UnitedHealth Group employs more than 13,000 people in the state.
Optum Labs will not be operated to generate a profit, said Andy Slavitt, group executive vice president at Optum. Mayo Clinic does not have an ownership interest in the lab, but will support it as a "strategic research alliance," Noseworthy said.
All patient data used by researchers in the lab will be stripped of identifying information to preserve confidentiality, Slavitt said. Optum will contribute data from more than 100 million patients who received care over a 20-year period; Mayo will contribute 5 million clinical records spanning a 15-year period.
"Optum and Mayo can't do this alone," Noseworthy said. "We'll be interested in asking other health care organizations ... to join this effort."
In the past, both groups have independently talked about working to define "best practices" for medical care, said Steve Parente, a health care researcher at the University of Minnesota. One stumbling block in such efforts, Parente said, has been the inability to bring together data from insurers and health care providers.
The new research effort is a high-profile example of trying to bridge the gap, but there have been others.
Parente pointed out that Bloomington-based HealthPartners has worked for years to improve care and lower costs by analyzing information from its health insurance operation as well as its growing network of hospitals and clinics. Another example, he said, is California-based Kaiser Permanente.
"This signals a sea change from the Mayo Clinic of old, where they didn't really care that much about the insurance industry," Parente said. "It also is a change for United. ... It offers a tremendous opportunity.
"Strategically, it's kind of brilliant because it's two very large national if not global brands," he added. "How much really comes out of it remains to be seen."
Whereas HealthPartners and Kaiser Permanente actually combine health insurance and health care delivery in the same organization, Mayo Clinic and UnitedHealth are not merging as part of the deal announced Tuesday.
The federal Affordable Care Act of 2010 encourages doctors and hospitals to take some of the financial risk for the health care costs of patients, and the push for these "accountable care organizations" has prompted some care providers to partner with insurers. But the Mayo Clinic and UnitedHealth are not creating such an entity, which is often referred to by its abbreviation ACO.
Still, the effort dovetails with some of the broader themes in the federal health law including a push for research that compares the effectiveness of competing treatment options. Officials said that Optum Labs, for example, would try to develop applications that measure the relative cost effectiveness of different medical devices.
The large data set available to researchers at Optum Labs could generate important discoveries about treating patients with common problems such as heart failure, said Dr. Veronique Roger, a Mayo Clinic researcher involved with the project.
Heart-failure patients often contend with the condition over long periods of time, making repeat visits to the hospital, Roger said. With the data at Optum Labs, researchers could better identify triggers for those hospitalizations, Roger said, and then development treatment interventions that help patients get better without needing a costly hospital admission.
"The goal, obviously, will be to share that knowledge with the medical community by research publication and other dissemination means," Roger said.
Noseworthy, the Mayo Clinic chief executive, added: "This really allows us to answer the really big questions in health care: What works best for patients with complex, costly illnesses that are really plaguing our health care system and making it unsustainable currently?"
Christopher Snowbeck can be reached at 651-228-5479. Follow him at twitter.com/chrissnowbeck.
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