Leadership meeting focuses on federal funding climate
The prospect of diminished federal financial support for health care services provided the backdrop for Vanderbilt University Medical Center’s Winter Clinical Enterprise Leadership Assembly, held Dec. 1 at Langford Auditorium. The quarterly forum was attended by about 900 managers and faculty.
With the nation’s mounting debt, federal legislators and President Obama are entertaining competing proposals to reduce payments to providers of Medicare and Medicaid services. Particularly of concern to Tennessee, and most other states, could be reduced federal financial support for Medicaid programs currently available to states by a process known as hospital assessment coverage.
Among other federal funding reductions currently being considered are cuts to funds intended to offset costs associated with training the nation’s next generation of physicians. Two forms of financial support for the nation’s teaching hospitals, Graduate Medical Education (GME) and Indirect Medical Education (IME) payments, are also undergoing scrutiny by federal legislators. In addition, significant reductions to NIH funding for basic and clinical research at universities are also under consideration.
VUMC’s leaders have been communicating with both federal and state legislators regarding the negative impact that could result from these funding reductions while simultaneously preparing financial models to address the impact should reductions materialize.
At the assembly, Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine, and C. Wright Pinson, MBA, M.D., deputy vice chancellor for Health Affairs and CEO of the Vanderbilt Health System, outlined VUMC’s strategy to succeed in the face of diminished federal financial support.
First, Balser, and later, Traci Nordberg, associate vice chancellor and Chief Human Resource Officer, reaffirmed Vanderbilt’s commitment to recruit and retain the very best faculty, students and staff to ensure the Medical Center’s legacy for discovery and the provision of the highest quality of patient care.
To help offset potential federal reimbursement reductions, VUMC will work to maintain its support from all commercial payers, including clinical research sponsors. The affiliations announced in September between VUMC and three Middle Tennessee medical centers — Maury Regional Medical Center, NorthCrest Medical Center and Williamson Medical Center — will help maintain competitiveness in the commercial market.
While no employee layoffs are planned, VUMC’s leaders and managers will exert a heightened level of oversight regarding vacant positions and the creation of new positions. Groups and divisions across VUMC will be encouraged to identify and eliminate redundant resources, and to strengthen and endorse shared space, infrastructure and administrative support.
All of these efforts will be aimed at strengthening the resources in support of VUMC’s highest priority, mission-central programs.
During their presentations, Balser and Pinson sought a balance between frank assessment of the challenges ahead and an opportunity to celebrate achievements. In the midst of his quarterly progress update, Pinson read a complimentary letter from the family member of a hospital patient.
“The care my mother received was the best I have ever seen at a medical facility. Vanderbilt has always been top-drawer to us and this experience just underscored this feeling,” the letter read. Pinson made clear his pleasure in receiving such letters. “Never underestimate the positive impact you as an individual can make,” he said.
Pinson stressed the new patient satisfaction goal of 80 percent “excellent” ratings for “overall quality of care,” and he presented the latest satisfaction data.
Other progress reviewed by Pinson included outpatient access (time to appointment), mortality rates, various health care acquired infection rates, adverse events (patient falls, bed sores), readmission rates, hand hygiene, patient volume, financial results and the status of various “innovation pillar” projects.
Pinson summed up management recommendations for progress in all these areas.
For details, see the Winter 2011 Leadership Assembly presentation materials on the elevate website (employee log-in required).
Nordberg outlined progress on “People Pillar” goals, including employee retention, job turnover, nurse turnover and employee satisfaction survey participation.
She also provided an overview for this year’s Community Survey results. Scores were high for cooperation, support from supervisors, benefits and belief in the organization’s mission. Areas needing attention include job evaluations, communication and “reward and recognition.” Supervisors will receive detailed satisfaction reports by mid-December.
Nordberg also detailed findings from four areas of VUMC with exceptional staff satisfaction scores: Unit 6C (Cardiology) at the Monroe Carell Jr. Children's Hospital at Vanderbilt, Orthopaedic Institute Rehabilitation Services, Medical Information Services and the Medical Intensive Care Unit.