The Mayo Clinic maintains a reputation of providing some of the best medical care in the world, but it comes at a price.

And that price is dramatically lower than many U.S. health programs, a situation that has drawn praise from President Obama.

In 2006, Medicare spent an average $6,688 per enrollee in the Rochester, Minnesota, area where Mayo is based, according to the Dartmouth Institute for Health Policy and Clinical Practice. The national average was $8,304—and it was thousands higher in parts of Texas and Florida.

Mayo officials say the difference comes from a philosophy that takes money out of the equation, making the needs of the patient the center of all that is done there.

“It’s working together with a focus on the patient,” said Jeff Korsmo, executive director of Mayo Clinic’s Health Policy Center and a former chief administrative officer for the clinic’s Rochester location.

For decades, Mayo doctors have received fixed salaries. That contrasts with many programs in the country where physicians have financial stakes in the hospital or practice. Critics claim this leads the unscrupulous to pad medical bills with unneeded tests and procedures.

“We try to remove any incentive for them to order more tests or do anything that really isn’t in the best interests of the patient,” Korsmo said.

An electronic record-keeping system is open to all medical professionals to review cases. Peers scrutinize doctors’ decisions, and this collaborative philosophical approach helps ensure the care adheres to the best possible practices.

“They all see the excellent care. But they also know that if anything about their care isn’t justifiable, it will be seen by others,” Korsmo said.

Mayo’s philosophy has diffused into care offered at other clinics and hospitals in Minnesota. The average cost of care in the state is about the same as Rochester.

Korsmo said most Minnesota doctors might not be paid on a fixed scale as they are at Mayo, but they are more likely than their counterparts across the country to work in group practices where physicians and staff collaborate on patient care.

“There were early pioneers like the Mayo Clinic, where they set this model for a group practice. A lot of the physicians in this part of the country trained in group practices, and they saw the value of it,” he said.

Mayo exported some of that culture, bringing health professionals with Mayo experience to Florida and Arizona when it opened facilities there in the 1980s.

Korsmo, who held an administrative post in Florida at the time, said it would be difficult for the government to establish a Mayo-like health-care system across the country. But he thinks a start would be to change Medicare reimbursement rules to reward doctors for quality of care rather than quantity of procedures ordered.

“What the government can do is create the right incentives to get people to work together to focus on the patient,” he said.