On the Money

Obamacare successful, but a 'long-term project': Clinic chief

Obamacare check up
Obamacare check up

In boosting his signature domestic policy achievement, President Obama once cited the Cleveland Clinic as a health care model to emulate.

Now, five years since the Affordable Care Act became law, how does that prestigious hospital's CEO think Obamacare is going? In an interview with CNBC's "On the Money," Dr. Toby Cosgrove says he sees some positive change.

"Health-care inflation has come down," Cosgrove tells CNBC. "We've seen quality metrics go up, and we've seen 13 million new people enrolled with coverage. So I think from those three standpoints, we've certainly seen a success."

Since assuming leadership in 2004, the former cardiovascular surgeon has built the Cleveland Clinic into one of the largest hospital organizations in the country. Last year, more than 5.5 million patients visited the clinic and its member hospitals.

Still, all the news hasn't been good for the clinic. The health-care powerhouse has retrenched financially, slashing part of its more than $6 billion annual budget, in what some observers linked to Obamacare reforms.

While Cosgrove declined to give the Affordable Care Act a letter grade, he calls it a "long-term project."

He added: "One of the things we have to do is keep costs down, and we have to sustain it. As more and more people come in and we have an older population, it's going to be more difficult to do."

Cosgrove said that as Obamacare continues, "we will see the effectiveness of maintaining cost controls in health care."

Streamlining, but improving access

Terry Donald, a beneficiary of the Affordable Care Act, is flanked by Sen. Chris Murphy, Democrat of Connecticut, and Sen. Al Franken, Democrat of Minnesota, during a news conference to discuss the Affordable Care Act case being heard at the Supreme Court on March 4, 2015, in Washington, D.C.
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Cutting costs is something he says the Cleveland Clinic has had to do. "We're about a $6.5 billion dollar organization. Two and a half years ago we looked at the future."

Cosgrove explained the math. "We planned to take $1.5 billion out in costs, about 20 percent," adding that in the past 18 months they've extracted about $500 million in costs.

One of the ways they've done it, he says, is through "Care Pass," a system of streamlining procedures. With "Care Pass," Cosgrove explains, "you take very best of how you do a procedure, take care of somebody, and standardize it. That takes out the variation. As you take the variation out, you improve the quality and reduce the cost."

The medical chief cited orthopedic surgery as an example of what's working. "Everybody (is) doing the same thing, the same way. We've seen lower infections, lower blood transfusions, shorter stay in the hospital and less cost."

Cosgrove tells CNBC he's most excited about progress that "takes care to the patient." He says Cleveland Clinic has made health-care access easier with more than one million same-day appointments a year.

Patients simply "call up and say, 'I want to be seen today,' " he said. Cosgrove added that "98 percent of the people who ask for (an appointment), get one."

He also mentions improved emergency room access has been a priority. "We've reduced the waiting time in the ER to 12 minutes, on average, in all of our hospitals."

Another innovation is that 2 million patients have their medical charts available via a mobile app called "MyChart."

Going mobile

Cosgrove told CNBC about the clinic's mobile stroke unit, one of only two in the country.

If a patient has symptoms that suggest a stroke, "we can dispatch a special ambulance equipped with a CAT scan to your home."

"If appropriate, you can get treatment right there in the driveway." The CEO calls it an innovation that "decreases travel time and saves brain tissue."

Cosgrove says the Cleveland Clinic will soon be expanding its "virtual visits" that take advantage of the ubiquity of mobile applications.

"People are going to be able to have a visit to their doctor on their Skype or their tablet or their iPhone. We're now seeing people who have post-operative visits, they can get their checkup with their doctor without ever coming back to the hospital from home."

What's behind these innovations, Cosgrove explains is that "we're headed towards is seeing patients anytime, anywhere."

"Wherever you are, you should have access one way or another to medical options."

"On the Money" airs on CNBC Sundays at 7:30 pm, or check listings for air times in local markets.