Lessons from Mayo Clinic’s Redesign of Stroke Care

Facing escalating costs of medications and technology, health care patients and providers in the United States continue to search for opportunities to reduce overall costs while maintaining and improving health care outcomes. At the Mayo Clinic Comprehensive Stroke Center Practice, we conducted a project to design and deliver care more customized to the needs of individual patients while reducing cost and resource constraints. It is a risk-stratified approach that could be applied to treating many medical conditions.

The team saw an opportunity to reduce costs based upon how and where patients received care, while still meeting Joint Commission requirements for post-TPA care, by treating low-risk patients in a NSPCU-level bed with a specialized hybrid level of nursing care (see the table below) for the first 12 hours. This risk-stratified care model improved value by delivering equivalent care quality with a lower-cost mix of resources. In addition, the stratification process allowed for better “demand elasticity” of ICU bed utilization.

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