Health Care Reform by Elizabeth Stawicki, Minnesota Public Radio

July 10, 2012

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ST. PAUL, Minn. There's a lot of jockeying for position in the health care market as medical centers prepare to implement the provisions of the federal Affordable Care Act.

The debate over the law has created a lot of uncertainty in the market, and many health care providers are responding by linking with each other to manage the risk.

The relationships range from outright mergers and acquisitions to more flexible relationships, called affiliations. Rochester-based Mayo Clinic has increasingly affiliated with smaller medical centers in and out of state through its Mayo Clinic Care Network.

"I've done more merger affiliations in the last 24 months than previously done in 23 years" as a consultant, said James Berarducci, a health care consultant in Minnesota for global management firm Kurt Salmon, who has done work for Mayo. "The issue now is, this isn't all about merging assets or being acquired; there are newer, different relationships that are being created."

Berarducci's firm has about 100 health care clients. He said Mayo Clinic's Care Network is a prime example of the newer relationships.

For a negotiated fee, or what Mayo officials call a subscription, affiliates receive direct access to Mayo's research and expertise in how to best care for patients. For example, Mayo doctors can render second opinions within about two days for an affiliate's particularly complex cases.

The network has six affiliates including Altru Health System and Coburn Cancer Center in Minnesota. It also has affiliates in Arizona, Michigan and Missouri.

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Amid uncertainty over health care law, Mayo expands