UMKC School of Medicine Advancing the Health of the Community Presentation to the Board of Curators September 2013

Transcription

1 UMKC School of Medicine Advancing the Health of the Community Presentation to the Board of Curators September 2013

2 UMKC School of Medicine UMKC Proposal Employ University Physicians Associates (UPA) doctors 140 Physicians - will retain UPA relationship Enables reimbursement at charges versus Medicare Strengthens UPA ($5 7M) - critical to teaching mission Competitive compensation Capacity to support research UMKC SOM stronger role in hiring process Sustains high quality of unique Six-Year Medical Program Current CRR is limiting requires change Limited exposure for UMKC in employment relationship

3 UMKC School of Medicine (Proposal impact on employment) Employment Issues Current Proposed Employer UPA UMKC SOM & UPA Compensation Reimbursement Rate Medicare Charges (Medicaid only) Hospital partner Truman Med Ctr Same University UMKC SOM Same Research Grants Small Increase over time Health Benefits UPA Same Retirement UPA Same Malpractice Insurance UPA Same Note: All other aspects of partnership remain the same SOM history, performance and promising future speak to proposal significance

4 UMKC School of Medicine CRR Highlights of 1971 Curator - Approved Plan: Graduate 100 MD s each year Academic plan based upon coordinated resources Affiliation agreements with hospitals No creation of patient care departments (Academic) Pay affiliates for teaching effort non tenured Change (UPA) Very few tenured faculty members Very large group of community physicians Intensive personal instruction in small groups (Docents) List of authorized affiliates Change

5 Truman Saint Luke s Children s Mercy Research Med Behavioral Medicine VA Medical Ctr

6 UMKC SOM Affiliated Hospitals Revenues and Patient Volumes # of affiliations 6 Admissions 75,000 Emergency Visits 450,000 Outpatient Visits 2 million Staffed beds 2000 Births 3000 Charity care Community Benefit Revenues Hosp. Hill Revenues All > $116 million > $280 million $2 billion $5 billion Outstanding clinical base for teaching and research

7 Advancing Community Health through Education Programs 40 years of excellent physician education Nearly 700 medical students Over 3000 MD graduates BA/MD MD Oral Surgery/MD Over 500 residents/fellows 14 core programs 31 fellowships Nearly half stay in region after graduation Strong outcomes in teamwork, communications, clinical skills Almost 50% of our graduates practice in MO..

8 Alumni Map 717 alumni in Greater KC 360 alumni in St. Louis area 302 Kansas Wyandotte and Johnson Counties 1,118 Alumni in Missouri

9 UMKC SOM Grant and Contract Expenditures (in millions) Total Research Federal Research UMKC SOM research expenditures significantly below peers

10 The Promising Future Existing Regional Assets: MU One Health, TIGER Institute, etc. Stowers Institute KU Med Center (NCI) Children s Mercy UMKC Outcomes Research Animal Health Corridor K-State NBAF Game-Changing Announcements: UMKC Bio-Informatics Center Hall Family $75 million facility for KCTMI Jackson County ½ cent Sales Tax November ballot $40 million/year for 20 years Translational Research CMH, UMKC, St Luke s, KCALSI UMKC SOM must increase medical research productivity

11 UMKC SOM Challenges Sustaining Academic Excellence Assist UPA in strengthening financial performance Attract and retain high-quality docents Increasing Research Capacity Current research expenditures are low UMKC has limited influence in UPA hiring decisions UPA lacks capacity to attract research oriented physicians Note: The proposed employment by UMKC will address both challenges More detail on UPA and how the proposal works is next

12 UMKC SOM Faculty Employment Model Over 950 Faculty 8 % Directly employed by UMKC SOM 2 % Tenured or tenure track 93 % Clinical 15 % employed by UPA 7/15 Dept Chairs Majority of Clerkship Directors 90% of Docents Faculty teaching of medical students supported through purchased teaching time (PTT) contracts with CMH, TMC, SLH, CBM, UPA UPA Faculty Practice Plan is essential to the medical education mission and key to growth in research.

13 UMKC School of Medicine Faculty Practice Plan University Physician Associates Missouri Non-Profit 501(c)3 Over one-third of medical school plans are independent entities Originally incorporated 1972 to serve UMKC and TMC Medical care of underserved/wellness Education (essential to UMKC medical education) Research Practice Management Billing, coding, compliance Employment of 140 physicians Third largest multi-specialty group in Kansas City Medical liability coverage

14 Missouri Medicaid State Plan Amendments Medicaid Enhancement 2001 MU Plan State Amendment Requires state employment Draws down federal CMS payments at charges for Medicaid fee for service 2003 UMKC (UPA) State Plan Amendment Requires UMKC faculty appointment Draws down federal CMS payments at Medicare rates Additional $2.8 million annual clinical revenue 2009 UMKC-employed physicians bill under 2001 plan 2013 Propose UMKC employ all UPA physicians

15 UPA UMKC Financial Impact Current Annual Medicaid Charges - $15 million Reimbursement at Medicare rates plus enhancement - $8 million Future Reimbursement at approved Medicaid Charges - $15 million

16 UMKC Structural Changes to Faculty Appointments/Employment Upon Approval UMKC to employ new UPA faculty part-time $1 million additional clinical revenue Each Year Move current UPA physicians to UMKC employment $5 million additional clinical revenue when fully implemented Increase Dean s fund from 2% to 6% of Net Pt Care Revenue Long-term (1-2 years) Update UMKC SOM faculty appointments for all clinical faculty at all affiliated hospitals Collaborate w/ MU faculty practice plan on future Medicaid enhancement plans

17 Summary of Structural Changes Legal with UPA Faculty Employment Participation in State Plan Amendments reviewed New Affiliation agreement with UPA Financial UPA faculty employment is revenue neutral to UMKC UPA remains separate 501(c)3 with financial risk, compliance risk, medical liability risk Substantially increases revenue to UPA and provides financial stability to the core teaching faculty Cost and risk neutral to UMKC.

18 Summary of Structural Changes with UPA Faculty Employment (cont.) Human Resources Two paycheck system Part-time employment of faculty (50% FTE for teaching) UPA covers benefits, retirement, etc. Majority of UMKC SOM faculty (including UPA) remain Non-Tenure Track (NTT) Academic Affairs Vast majority of UMKC SOM faculty will continue as NTT Participate in ongoing UM System review and updating of faculty appointments, ranks, promotions processes

19 UMKC School of Medicine: The Future Advance the health of Kansas City and Missouri through education and research Continue excellence in medical education through successful community partnerships Grow research programs through partnerships UMKC Affiliated Hospitals UM System Contribute to economic development and stability in Kansas City s urban core Advancing the Health of Missouri depends on the UM SOMs in Kansas City and Columbia

20 UMKC Hospital Hill is a vibrant urban health science campus vital to the future of Kansas City and Missouri.