Second Organizational Meeting of the UMC Ad Hoc Hospital Review Committee.

Not the promising start I had hoped for. Secrecy and control still in abundant evidence.

The Ad Hoc Operations Review Committee of University Medical Center, Inc. (UMC) met yesterday, March 12, 2012, for the second time. [Read about the history of this committee herehere, and here.]  I counted six of the 10 members present, three of whom were outside Committee members. There had been some “briefing” beforehand that I suspect will not show up in the minutes of the meeting. (TC #1) [Minutes of last meeting here.]

A new potential partner!

Perhaps the most interesting piece of news was that the healthcare strategy firm that had been updating the 2008 report of UMC’s financial future just notified the hospital that they had been hired to represent another hospital system that intended to respond to UMC’s request for proposal (RFP) for a new system-wide partner! (I had suspected as much from the content of some of the questions proposed in writing following the Pre-Proposal Conference.) The potential responder (not KentuckyOne Health) appears to be serious, although the opportunity to gather business intelligence as a motive cannot be dismissed by me at this point. Continue reading “Second Organizational Meeting of the UMC Ad Hoc Hospital Review Committee.”

Review of UofL Hospital by Kentucky Auditor of State Accounts.

An Open Letter to State Auditor Adam Edelen.

Re: An appeal to make broad your audit of UofL Hospital.

Dear Mr. Edelen,

Although it is like pulling teeth, small amounts of information about the financing of the University of Louisville and its University Hospital are slowly becoming public. The public is aware that your office is looking at the University’s handling of its QCCT funding for indigent care in its hospital. I am writing to try to convince your office that examination of QCCT funding alone is insufficient and that to fully judge whether the state and local components of that fund are truly being used to the best advantage of the public, other aspects of University accounts must also be examined.

For example, in last week’s release of information in response to questions submitted by potential responders to the University’s RFP for a new partner, the amounts of transfers from University Hospital funds to the University were outlined to the tune of $74 million of the $430 million of hospital clinical revenues. More than 17% of hospital revenues go directly to the University! Some of this is Medicare money designated to pay the salaries of Residents, but under its ongoing veil of secrecy the University does not detail where its money came from, nor how it is spent.

Given that the University has a long history of pooling its state money and using it as it sees fit, and in the wake of the Passport and other scandals, the public is entitled to a fully justified explanation. How else can we know whether the $34.4 million of current QCCT funding is too much, too little, or just right. A dollar of money drawn from the QCCT means another dollar that might legitimately be used to support indigent care can be spent elsewhere. Indeed, I believe the whole concept of the QCCT fund needs to be revisited. Why, for example, should not state indigent dollars follow the indigent, no matter where that service is provided? Why shackle the indigent to a place they may not care to go? Does the current QCCT reimbursement formula lead to artificially higher charges to all patients at the hospital? Does having a captive patient population blunt faculty motivation to make University Hospital the most desirable and highest quality hospital in town? To make such determinations, the public needs a full audit of the University of Louisville, its Foundations and Hospital. Continue reading “Review of UofL Hospital by Kentucky Auditor of State Accounts.”

Ongoing Planning Between UofL and KentuckyOne Health.

Does all Kentucky business happen at basketball games?

I made an interesting field trip to New York City last Friday. By accident, I discovered that the University of Louisville’s Department of continuing medical education was offering a seminar in the Big Apple entitled, “What We Can Learn about Hospital Mergers, Capital Investment and Construction in a Landlocked Urban Environment.” This topic sounded familiar! Given all the excitement about religious intermarriages of hospitals, I thought it would be interesting to hear what some of the players would have to say off the battlefield. It took a few phone calls, but eventually I got my name on the list. As I learned later, this meeting was part of an annual affair for University officials and faculty going to the Big East basketball tournament. Physician members can get some of continuing medical education credits necessary for licensure. The trip also gives University representatives a chance to visit other medical schools and teaching hospitals and to talk about things like technology transfer and mergers. This year’s field trip included a visit to Mount Sinai Hospital and Medical School which had recently gone through a high-profile marriage with New York University, and an even higher profile divorce.

There were some 20 people in attendance at the conference– a pretty high-powered team. President Ramsey, Provost Willihnganz, Vice President Inman (development, governmental relations, and marketing), and the Deans of the Schools of Medicine and Education made up the starting five. On the bench were the director of the University’s Residency Programs, and various division chiefs and program directors including neurosurgery, neurology, and anesthesia. I was actually shocked to find in attendance two very senior officials from Jewish Hospital who were leaders in last year’s failed merger attempt. This was not a party to which I would have been invited had I not crashed it myself. A few of the group were obviously not happy I was there and I suspect their conversations following the scholarly presentations of the conference were guarded in my presence.   Continue reading “Ongoing Planning Between UofL and KentuckyOne Health.”

Follow-up on UofL’s Search For a New Partner:

Responses by University of Louisville to questions from potential applicants to its RFP.

On March 9, the University of Louisville released its responses to questions submitted following its pre-submission conference on February 28. Some of these answers clarified questions asked at the conference. An e-mail containing the information was sent to 36 individuals and was posted on the UofL website. Most of the recipients were University of Louisville people, but there were individuals from Norton, Catholic Health Initiatives, Baptist Hospital, Jewish Hospital, Stites & Harbison, Kauffman-Hall, Price-Waterson, Health Management Associates, and yours truly.

A total of 71 questions were responded to, or requested information provided in attachments, but amazingly little was revealed. Eighteen of the questions were dismissed with the equivalent of “read my mind,” “you tell us,” “depends on your proposal,” or “will tell you after we have decided.” Bare-bones information seems to be the rule of thumb. These were not the responses I would have expected from an organization that was seriously soliciting responses from a major-league player. “Brush-offs” is a term that comes involuntarily to my mind as I read the responses. You can judge for yourself. Please tell me in the comments section if I am being unnecessarily harsh. Continue reading “Follow-up on UofL’s Search For a New Partner:”