UC Health can expand its reach and offer new services while exercising a disciplined approach to the financial challenges in health care, President and Chief Operating Officer Jim Kingsbury says.
"We have money; the question is: How do we use it wisely and how do we allocate it?” Kingsbury said Monday, May 20, during a presentation in the Medical Sciences Building’s Kresge Auditorium. A crowd of about 200 was on hand.
Kingsbury’s talk was the sixth and last in a series of senior leadership presentations by the College of Medicine and UC Health. They included a Nov. 8, 2012, presentation by Thomas Boat, MD, dean of the College of Medicine and UC vice president for health affairs, in which he discussed progress made since he presented his vision for the college in October 2011.
In the past three years, Kingsbury has led UC Health—the University of Cincinnati’s health system—through its transition from the remnants of the former Health Alliance. It includes UC Medical Center, University of Cincinnati Physicians, West Chester Hospital, Drake Center and the Lindner Center of HOPE, co-owned by the Lindner Family Foundation. Last week, Kingsbury announced that he would retire in fall 2013 and asked the UC Health board to start planning for transition to a new president and CEO.
In his talk Monday, Kingsbury compared UC Health’s current situation to the construction of a house. Quick and visible progress comes early, he said, while progress may slow now in the finishing details as the project moves forward.
"We are now developing the details of our system, and that’s harder and slower because there are more people involved, more details and opinions on the options,” he said. "We are becoming more focused to make the priorities real.”
Those priorities, according to Kingsbury, include:
• A second patient tower at West Chester Hospital, which is under consideration and which he estimated would cost as much as $135 million and take 2 ½ years to complete. It would include maternity and obstetrics services, which are not currently offered at the hospital.
• An increased community presence for UC Health facilities, with enhanced, convenient access for patients and employees at newly constructed ambulatory centers extending from Northern Kentucky to as far north as Trenton, Ohio.
• An expanded primary care network, with extension of the UC Health brand into new communities via free-standing primary care network offices.
• A retail clinic affiliation strategy, which would involve creation of a low-cost medical service provider tier at an existing network of retail stores. Such a move would represent a low-cost extension of the UC Health brand into the community, Kingsbury said.
Kingsbury also pointed to recent successes, such as the opening of the UC Health Women’s Center in West Chester, a renewed impetus for the UC/UC Health institutes and restoration of the UC Department of Pathology and Laboratory Medicine’s clinical services within UC Medical Center.
While growth within the Greater Cincinnati health care market is flat, Kingsbury said, UC Health hospital volume is growing significantly, with West Chester Hospital accounting for 70 percent of the total share growth. In addition, UC Health’s inpatient market share is growing consistently and at a greater margin than other systems in Greater Cincinnati.
UC Health will finish Fiscal Year 2013 with a $14.1 million operating margin deficit, Kingsbury said, attributing that to one-time costs totaling $20 million including implementation of the Epic electronic medical records system, $5 million for physician recruitment and costs of adding 135 beds and accompanying staff at UC Medical Center. The preliminary budget for Fiscal Year 2014 shows an operating margin back in the black at $26.9 million.
"We did that knowingly, thoughtfully investing for the future,” Kingsbury said of the expenditures. "I hear too often the comment, ‘We don’t have enough money.’ The first lesson is, no one does. It’s really a question of setting priorities and using your resources wisely.”
Crucial to future success, Kingsbury said, is Project E, an effort to create and sustain new models of effectiveness, efficiency, empowerment and "exceptionalism,” born out of the need to align and support the tripartite missions of UC Health: clinical care, teaching and research. Project E’s two major goals are to attain the upper 25th percentile in performance and produce a 5 percent positive margin.
"I believe that you can increase the quality of care and decrease cost at the same time,” Kingsbury said. "They are not mutually exclusive, and the best organizations in the country do exactly that.”
Also crucial to UC Health’s success, Kingsbury said, is Plan 2017 (20 initiatives, 1 system, 7 actions everyone in the system can do to make an impact), implemented in October 2012. It’s a five-year plan, he said, with specific matrixes.
"If we are successful with Project E, meaning it gets us to a 5 percent margin, it puts around $40 million a year in additional resources that we can allocate to the things that we want to do.”
UC Health’s financial goals include fully supporting the Joint Strategic Plans of UC Health and the UC College of Medicine, and providing adequate funds flow to the College of Medicine, Kingsbury said. Over the past year, the Chartis Group consulting firm has assisted Boat, Kingsbury and other College of Medicine, UC Physicians and UC Health leaders in developing a new fund allocation system that matches the structure, principles and philosophy of UC Health’s new organizations. Discussions are now underway with department chairs and business managers with the goal of making sure the right amount of money goes to each department to support each mission via a new funds flow model with improved algorithms.
"The more successful we are, the more funds flow to UC Physicians, the College of Medicine and the academic departments,” Kingsbury said.