Growth is a popular word in Rochester as new hotels, apartments and restaurants seem to pop up daily in the wake of the Destination Medical Center initiative.
Revenues at Mayo Clinic, ranked the top hospital in the world by Newsweek magazine, are on the rise. So, too, are the clinic’s capital investments in Rochester.
Mayo Clinic has increased its Rochester employee base by 17 percent, from 30,583 local employees in 2013 to 35,895 in 2018.
At the heart of any discussion about Rochester and DMC are the thousands of Mayo Clinic patients who flock to the city with family and friends every day.
However, while so many other aspects are booming, Mayo Clinic reports that there has been no growth in the overall number of patients treated during the first years of the DMC initiative.
From 2010 to 2014, the number of individuals treated annually at Mayo Clinic’s sites including Rochester grew by a total of 276,900 patients, or 25.5 percent.
But that growth streak ended in 2014, the first year of DMC, when Mayo treated 1.3 million patients. Mayo Clinic has reported treating 1.3 million patients each year from 2014 through 2018 with no increase or decrease.
While it is not a direct comparison, Cleveland Clinic’s total outpatient visits grew by 19 percent, from 6.62 million in 2015 to 7.9 million in 2018. Newsweek ranked Cleveland Clinic as the second-best hospital in the world.
What does the stagnation of Mayo Clinic’s patient count mean for Rochester as the city bristles with construction cranes and safety cones? Could Rochester be seeing more patients, while the overall number stays flat due to decreases elsewhere in Mayo’s system?
It’s hard to directly answer those questions, because Mayo Clinic’s concern about competitors causes them to keep some patient numbers private.
“We consider our site volumes to be proprietary information, but will continue to report volumes and other statistics at an enterprise level,” wrote Mayo Clinic spokeswoman Kelley Luckstein.
Mayo Clinic Chief Financial Officer Dennis Dahlen explained that Mayo Clinic’s competitors are watching closely to track its growth.
“Everybody is looking for surrogates for whose business is growing and whose is not,” he said. “The easy way to satisfy your competitor’s curiosity is to share publicly your side-by-side volume numbers, so we made a decision not to do that.”
Cleveland Clinic, Johns Hopkins and other medical centers have similar policies regarding patient numbers.
While the number of patients treated at all of its sites is the only statistic available, Dahlen cautioned that it is not a very firm figure.
“We don’t go any more detailed than 1.3 (million), because there’s some margin of error in that number. We accumulate that number from a variety of IT systems. Up until implementation of Epic, we were on something like 16 revenue cycle billing systems and so we couldn’t control for duplicates and a host of other things,” he said. “We’re honestly being a bit cautious in not being more precise in that number, so the 1.3 number is not exactly 1.3 million every year.”
While the specific numbers in Rochester aren’t available, Mayo Clinic patients and visitors are important to the Med City’s economic health.
Experience Rochester, the local convention and visitors bureau, reported that 3.34 million visitors stayed overnight in Rochester in 2017.
Mary Gastner, the interim executive director of Experience Rochester, said that of those 3.34 million visitors, about 69 percent were here for some reason related to Mayo Clinic. Visitor numbers for 2018 have not been officially tallied yet, but Gastner estimated that the percentage of Mayo Clinic visitors would be comparable to 2017.
Dahlen emphasized that while the number of patients has not shown growth, Mayo Clinic is seeing patients with more complex needs that require more visits and stay in Rochester longer.
“The intensity of the care provided patients isn’t static …. We’re seeing more intense patients with longer stays,” he said.
Patient visits in Rochester have been growing by a steady rate of 1.5 percent every year, since 2009, according to Dahlen.
Mayo Clinic tallied 4.7 million patient visits at all of its locations in 2018, he said. Due to concerns about the computer system transition, Mayo Clinic did not provide patient visit totals for any years prior to 2018.
That steady annual increase of patient visits is a factor driving the clinic’s future.
“Mayo Clinic growth is carefully planned, and patient needs are the key driver as we look to the needs for more staff and infrastructure that supports our patient’s medical challenges,” wrote Mayo Clinic’s Luckstein.
As the number of individual patients has remained flat, Mayo Clinic’s revenue from patient care has grown 17 percent from 2014 to 2017 to $3.06 billion.
With revenue up, how important is treating more patients when it comes to Mayo Clinic’s growth?
“Patients are just one input into overall growth,” said Dahlen. “We have non-patient visits. We’ve got new start-ups. Our patient numbers don’t include the growth in the Mayo Clinic labs and a host of other things. There are many dimensions of growth.”
Rochester Mayor Kim Norton, who helped pass the DMC legislation when she was a state lawmaker, said the initiative has always been about growth.
“We talked about Mayo staying and growing in Rochester. We didn’t talk about a particular aspect of that growth. Was it new patients? Was it patients staying longer? Was it patients returning more often. We didn’t get into those kind of details,” she said.
Norton added that it didn’t concern her to hear that Mayo Clinic’s patient-treated numbers have been flat.
“I’m not alarmed … It’s Year 5 of a 20-year plan,” she said. “There’s no script for this.”
Mayo Clinic’s Dahlen stressed that the growth promised as part of the DMC initiative is happening.
“My understanding is that it (DMC) was prefaced on growth and economic activity, including patient volumes. But it is really focused on the development of an ecosystem around bioscience and bio-manufacturing and the whole health care sector spinning off the research and innovation created at Mayo Clinic,” he said.
What about the DMC-driven push to upgrade the city’s infrastructure?
“All those businesses and enterprises need water, sewer, parking and have employees,” Dahlen said. “It’s admittedly a different vertical or different segment of the ecosystem. Inside Mayo Clinic, it’s the growth aspect of DMC that we are most excited about,” he added.
The team at the DMC Economic Development Agency said patients are a key piece to the DMC puzzle.
“Patient growth is absolutely part of the DMC vision, as is the growth of all businesses in Rochester, including startups,” wrote DMC Director of Communications Bill Von Bank. “The work of DMC is to help to attract new businesses and create an environment for all businesses to prosper.”
In the end, Dahlen said patients are the cornerstone of Mayo Clinic.
“By sheer dollar volume and economic activity, the practice dominates the overall enterprise. It is why we are Mayo Clinic … to treat patients, and it has always been that way,” he said.