May 24, 2013

Message from the Vice Chancellor for Health Affairs about economic position

In recent communications I have highlighted the intense financial challenges we are facing as a leading academic medical center, particularly during this last quarter of the fiscal year.

In recent communications I have highlighted the intense financial challenges we are facing as a leading academic medical center, particularly during this last quarter of the fiscal year. Like our peers across the country, we have been reeling from the effects of sequestration and other federal legislation that abruptly reduced payment through not one, but three of our largest federal revenue streams – Medicare, Medicaid and the National Institutes of Health (NIH).

As we approach the end of a fiscal year of unprecedented challenges, I can’t emphasize enough how your commitment, reasoned reactions, and sacrifices are making it possible for us to adapt to these challenges while keeping our mission critical programs moving forward.

Our hospitals and clinics are full, and our educational programs are hitting new records for numbers of applicants and student quality. Despite the most competitive circumstances in decades at the NIH, our faculty are achieving grant funding at remarkable rates against almost impossible odds. The impact of your resilience is unmistakable – locally, nationally and throughout the globe.

As we look forward to a new fiscal year, it is important for us to continue to communicate with clarity about measures we will continue, those we will discontinue, and temporarily halted processes we will allow to resume.

First, our health care system is growing locally and throughout the region at a robust pace. We will continue to hire for roles with direct patient care responsibility through a review process by hospital and clinic leaders. As we do so, our focus on building clinical programs distinctive in nature and quality, in our region and throughout the nation, remains a high priority.

Second, with the continued success of our investigators at achieving grant funding from federal, corporate, and foundation sponsors, it is essential that we begin filling more positions supported through these awards.

While we continue to work to fill as many of these positions as possible with individuals already working at Vanderbilt during the final quarter of the fiscal year, it is clear we need to begin external recruiting soon. We are therefore now allowing postings for research positions funded by outside sources with hire dates on or after July 1, 2013. Posting for non-direct patient care positions funded by internal VUMC sources will be considered after July 1, and will receive detailed review by Medical Center leadership. The process for submitting such positions for consideration will be provided through divisional leaders in mid-June.

Third, your patience, support, and leadership as a community as we have held vacation accrual is making it possible for us to avoid salary reductions and major workforce reductions during this fiscal year. As planned, we will lift the hold on new vacation accrual beginning July 1, 2013. At the same time, we are assessing best practices among peer organizations surrounding vacation time and sick leave, particularly centers implementing designs that provide more flexibility during different life stages while managing the accounting requirements and costs for backfilling absences. We will be sharing those plans with you in the coming months.

Our leadership team is intensely monitoring the operating and financial performance of the entire Medical Center, and we will continue to inform you of challenges and progress. As highlighted in my most recent Rounds column, VUMC has pulled together in an extraordinary way, and many, many areas have found cost efficiencies through more judicious use of supplies, or through reconfiguring manpower to cover more functions with fewer people rather than filling a vacancy with a new employee.

These efforts and many more will continue in earnest into the new fiscal year, and are fundamental to strengthening our operations and finances for the future. As we embark upon comprehensive efforts to reduce cost through improved efficiency and effectiveness, our anchoring values are steadfast: to preserve the tremendous quality and impact of our mission-central programs in health care, education, and research. The Vanderbilt culture is to tackle this kind of challenge not as individuals, but as a mutually supportive community. As is our custom, we will engage this difficult work with a sense of team spirit, creative energy, flexibility and commitment.

Please take time this summer to enjoy your families and friends. I will continue to communicate frequently on these and other topics as we work together to provide leadership for our community and to our nation during a time of unprecedented change in health care and biomedical science.

Jeff Balser, M.D., Ph.D.

Vice Chancellor for Health Affairs and Dean of the School of Medicine