Developing Our Network
As the region’s only academic medical center, URMC has long enjoyed collaborative partnerships with community hospitals, strengthening their ability to provide primary and secondary care in their own communities. As health care reform dictates that health systems assume responsibility for large populations of patients, URMC has engaged in discussions with a number of community hospitals, exploring potentially deeper relationships. These relationships will require a more consistent and cohesive way of blending faculty and community physicians. In 2011, the University of Rochester Medical Faculty Group (URMFG) launched a strategic planning process that promises to fundamentally restructure the way that URMC physicians work together, with private practitioners, and with all the institutions who care for our patients.
Across the country, hospital systems are considering new relationships that can help them drive down costs and improve quality. In addition, as medicine becomes more specialized, sub-specialty physicians need to serve larger populations to be financially viable. As payments to hospitals shrink and the cost of technology skyrockets, it’s paramount for community hospitals and academic medical centers to collaborate, ensuring that patients are directed to the setting in which they can receive the best possible care at the lowest possible cost. The successful affiliation between Strong Memorial and Highland Hospital over the last 15 years serves as a model of how an academic medical center can work with a community hospital to create value.
In 2011, URMC signed an agreement with Lakeside Health System to make the Brockport-based hospital a Collaborating Partner. Even before the formal agreement, Lakeside and URMC had been working together for more than a year on ways to strengthen health care services in the Brockport area – bringing cardiology, urology, orthopaedics, and ENT services to that area by establishing URMC practices that admit patients to Lakeside and providing options for care at Strong Memorial and Highland Hospital for high-intensity care for those patients who need it. This Collaborating Partner agreement institutionalizes this relationship. It’s a formal commitment on the part of both organizations to continue to extend the range of services available in the Brockport area, and it allows us to test a different kind of institutional collaboration with a hospital in a community that’s further removed.
At the close of 2011, URMC was in discussions with the Canandaigua-based Thompson Health System to form a Highland-style affiliation with the Medical Center. The talks took a major step forward in December when the Thompson Health Board of Directors unanimously approved an Agreement in Principle, a set of terms that will serve as the framework for Thompson to become part of URMC’s health care network. While both health systems still require board approval of a final deal, the Agreement in Principle represents a major milestone in talks that could better prepare both systems for health care reform opportunities and shrinking reimbursement. An affiliation could theoretically increase the systems’ abilities to provide more cost-effective services at Thompson that would, in turn, free up capacity at URMC for patients with more complex needs. Dozens of programs and services at Thompson within 14 medical and surgical specialties, including cardiology, neurosurgery, oncology, psychiatry, and more, are already provided by URMC faculty physicians.
Not only will the health care of the future demand greater collaboration among organizations, it will require a deeper, more fundamental teamwork among the physicians who provide care at URMC institutions. New financing mechanisms require hospitals and physicians to share medical and financial accountability for the patients they serve. The trademark structure of traditional academic medical centers – with its departmental silos and exclusive membership by faculty physicians – simply won’t serve a delivery system premised on multidisciplinary care, increased accountability, and shared risk.
Under the leadership of newly appointed Senior Associate Dean and URMC Medical Director Raymond Mayewski, M.D., URMFG has retained national experts to help develop a strategy that aligns faculty across departments and with the hospitals to create a more cohesive clinical enterprise.
The goal is to position URMFG as an academic practice that leads the region in outcomes, efficiency, and service. Leaders expect to have a plan developed by mid-2012, enough time to become adept with the changes before the full impact of Medicare and Medicaid cuts is felt in 2015.