Essay About Integrated Delivery System And University Hospital

University Medical Foundation
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University Medical Foundation (UMF), Inc., is a not-forprofit
corporation formed by physicians in the College of Medicine at
Southeastern University. UMF, with over 600 physicians, provides the
medical staff for University Hospital. In addition, UMF staffs and administers
a network of 25 ambulatory care clinics and centers at ten
locations within 50 miles of the hospital. In 2002, UMF generated over
$500 million in revenues from about 40,000 inpatient stays and 750,000
outpatient visits.
Over 70 percent of UMF’s revenues currently come from inpatient
stays, but this percentage has been declining, and by 2005, over half of
UMF’s revenues are expected to stem from outpatient services. As improvements
are made in technology and third-party payers continue to
pressure providers to cut costs, more and more inpatient services will
be converted to outpatient and home care. For example, in 1992, 80
percent of UMF’s ophthalmological surgeries took place in University
Hospital, while in 2002, 80 percent were conducted in outpatient settings.
Although UMF has traditionally provided only specialty services, in
1998 it instituted a “personal physician services” program, in which
patients can receive both primary and specialty care from College of
Medicine physicians. This was the first step in UMF’s drive to develop
an integrated delivery system, which offers a full range of patient services.
Now that the system is in place, UMF is contracting with managed
care plans to provide virtually all physician services required locally
UNIVERSITY MEDICAL
FOUNDATION, INC.
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by plan members. Furthermore, UMF is examining the feasibility of
contracting directly with employers, and hence bypassing managed care
plans, but no decision has yet been made. Indeed, state insurance industry
representatives expressed opposition to the idea when UMF first
announced the possibility of direct contracting. The insurance industry
position is that direct contracting with employers to provide a complete
healthcare benefit package is an insurance function, which can
be undertaken only by licensed insurance plans.
As part of its continuing education program, UMF holds monthly
“nonclinical grand rounds” for its physicians, in which various staff
members and outside specialists conduct