THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Friday, December 29, 1995 TAG: 9512280030
SECTION: FRONT PAGE: A10 EDITION: FINAL
TYPE: Opinion
SOURCE: By PERCY WOOTTON, M.D.
LENGTH: Medium: 80 lines
Imagine the commonwealth of Virginia with no resource to educate its future doctors, nurses and medical researchers. Imagine the commonwealth with no hospital facility to care for adults and children who cannot afford to pay for medical care. Imagine the health-care marketplace in Virginia without its two teaching hospitals - which employ approximately 9,000 people in Richmond and Charlottesville.
We may not have to leave those scenarios to our imaginations if the state's two teaching hospitals - Virginia Commonwealth University's Medical College of Virginia and the University of Virginia Medical Center - stay on their present tracks: tied to state regulations. In the upcoming General Assembly session, Virginia Commonwealth University will ask the legislature to form a separate governmental public authority - or quasi-private entity - for its teaching hospital, a plan that will help the academic medical center survive by giving it flexibility in personnel issues, capital planning and outlay and purchasing matters, making it stronger financially. This is not a request for separation from the state - MCV Hospitals has no interest in that. Under the public-authority model, MCV Hospitals will remain part of the state.
The academic medical centers and undergraduate medical education in Virginia are at serious risk. To better understand the need for the VCU's hospital to become an authority, consider these facts:
About 29 percent of VCU's medical-school budget is derived from state funds. In 1993-94, VCU ranked 66 out of 74 public medical schools in the country in terms of state support per medical student.
It costs about $70,000 a year to educate medical students at VCU/MCV. Clinical practice and hospital revenues for health services are the major source of this funding. In fact, these revenues provide more than half the medical school's budget. If MCV Hospitals cannot effectively compete in the managed-care market, hospital and clinic revenues will rapidly decrease and that will mean increasingly less support for undergraduate medical education.
With increased competition, declining federal funding of Medicare and Medicaid and reduced payments from insurance companies, MCV Hospitals projects an 18 percent to 25 percent decrease in clinical revenue over the next five years - which translates into less funding for the education of medical students.
MCV Hospitals and MCV Associated Physicians provide 35 percent of Virginia's indigent care - which includes more than $30 million of unreimbursed care each year - a loss neither the hospital nor the practice plan recovers.
The authority model is a self-help method of survival. It will allow the hospitals to respond to managed-care challenges and remain viable in the health-care marketplace. The authority model will allow VCU to become more efficient and competitive; increase revenue; continue to provide support for medical education and enhance our ability to be as self-supportive as possible. The university does not expect the General Assembly to open the door to increased and limitless funding for MCV Hospitals. Proposing an authority model is a major piece of VCU's plan to help itself financially and is a means of fulfilling its mission to increase revenue and help pay for medical education.
Increasing MCV Hospital's competitive posture will enhance the likelihood of achieving needed partnerships with its counterparts in the health-care delivery business - something that is very difficult now. Under the governmental authority model, there would be far greater likelihood of higher earnings and of increased job security.
I can testify to the sound medical education one receives at VCU and U.Va. Our two teaching hospitals have provided medical education and services to Virginians for nearly 200 years. The creation of public authorities for each of our hospitals would greatly improve our ability to compete effectively in the health-care market. To deny the hospitals this request would be a disservice to the best and the brightest Virginians awaiting to attend these nationally recognized institutions, and to all Virginians who stand to benefit from the care the doctors, nurses and researchers provide. Let's hope the Virginia legislature will look to the authority model to protect the foundations we have built. MEMO: Dr. Wootton is a cardiologist in Richmond, a member of the Virginia
Commonwealth University board of visitors and a graduate of the VCU/MCV
School of Medicine. by CNB