June 21, 2006

UTMB Downsizing and Increasing Revenues [That's the plan, anyway]

Galveston Daily News article here, the President of UTMB's message here.

Interesting bits from the President's speech:

The consultants didnít tell us anything we donít already know, although it wasnít easy to hear that we have serious productivity issues.

The Navigant group has proposed a target in the neighborhood of 1,300 full-time equivalents (or FTEs). However, until the SEC has evaluated the entity leadersí plans, thereís no way to say precisely how many positions will be affected or in which areas.

Weíre also committed to increasing the number of commercially insured patients we see and treat.

Tasty bits from the News:

Of the 15 entities in the University of Texas system, the medical branch has by far and away the largest ďadjustedĒ operating deficit, meaning the institution is spending more than the ongoing revenue itís taking in if the cost of replacing buildings and equipment is factored in.

Presently, about 85 percent of the institutionís clinical income is from patients with Medicare, Medicaid or some other form of government-sponsored care.

So, my questions would be:

1) How many of the patients treated are completely unfunded?
2) Of the patients with Medicaid or Medicare, or private insurance, what percentage of cases actually end up paying?

Both of these are problems that UTMB has been working on for a while, and maybe they've gotten better, but I don't know.

3) They've tried opening up exclusively private pay clinics in the past, with varying levels of success. But, there's a catch22:

Assuming the patient has the ability to go anywhere:
If he's initially being seen by a medical student or a resident, why wouldn't he go somewhere else? If not, if the medical faculty is as productive as he could be in a private practice, why the heck wouldn't the doc leave and make some real money?

It is, of course, more complicated than that. Some docs love teaching, or research, or interaction daily with collegues... There are advantages. But there are also disadvantages- you aren't your own boss, and sometimes can get assignments that have nothing to do with what you want to do.

4) They want to significantly increase income from research. But this requires time and energy, as well as skills that significant portions of the faculty don't have [writing a proposal for a national grant is difficult and specialized, and isn't really ever taught]. And the people with those skills are largely gone, at least in psychiatry. Except for the Chair and Vice Chair, anyway. A couple of other exceptions.

Interesting. I'm trying to find a listing of current psychiatry faculty on the website, and can't, even knowing various tricks.

Even more interesting, in an awards notice, Dr. Michael M. Stone is noted as co-director and lecturer for the psychotherapy curriculum for psychiatry residents. He's a smart guy and a great doctor, but if he's the best psychotherapist they have left, that's interesting.

Posted by Owlish at June 21, 2006 06:22 PM | TrackBack
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