As part of a clinical integration project that began in 2012, The Nebraska Medical Center, Bellevue Medical Center and UNMC Physicians have formed a new, unified leadership structure which leaders say is “built for the future.”
The Nebraska Medical Center, a private, non-profit hospital was created in 1997 with the merger of University Hospital and Clarkson Hospital. UNMC Physicians is the faculty medical group of the University of Nebraska Medical Center, the state’s public academic health science center. Bellevue Medical Center, owned jointly by The Nebraska Medical Center, UNMC Physicians and a group of private physicians, opened in 2010.
In their current structures, The Nebraska Medical Center, Bellevue Medical Center and UNMC Physicians each have their own administrations – boards of directors, chief executive officers, and presidents.
In the new leadership structure, a single board will govern the newly formed clinical enterprise and a two-person executive team will lead it.
Leaders from all entities involved have selected Bradley Britigan, M.D., dean of the UNMC College of Medicine, as interim president, and Bill Dinsmoor, chief financial officer of The Nebraska Medical Center, as interim chief executive officer.
“This will be an organization built for the future,” Dinsmoor said. “We’re in the midst of a profound and historic change in the way health care is organized and delivered.”
“Organizations that are standing still will find their existence threatened,” said Dr. Britigan. “That is not where we want to be. We want to be out in front and leading the pack.”
"It is more important than ever that our entire clinical enterprise be aligned, strategic and focused,” said University of Nebraska President James B. Milliken. “This new structure, thoughtfully developed with the involvement of scores of key health care leaders, positions us very well for success in this new era."
“Care has become increasingly complex,” said Carl V. Smith, M.D., president of UNMC Physicians. “Patients no longer have one problem; they often have several chronic conditions simultaneously. That care must be provided in a cooperative manner across geography and across disciplines.”
Retiring president and CEO Glenn Fosdick shared, “I’ve worked closely with Bill Dinsmoor over the last 12 years. He’s sharp, entrepreneurial and works well with physicians. He’s the most logical person to serve upon my retirement.”
Fosdick played a critical role in the recruitment of Dr. Britigan from Cincinnati two years ago. “Brad stood out as a top candidate with his impressive experience integrating academic and clinical organizations,” he said.
The three organizations expect to begin officially operating as one on July 1, 2014. Dinsmoor and Dr. Britigan are expected to name the leaders in other key positions of the new structure in the next few weeks.
“Unifying our organizations will foster greater collaboration and support for our clinical, education and research missions.” Dr. Britigan said.
Among the goals of the new alignment:
- To be national leaders in clinical quality and outcomes
“We’re already known internationally for things like cancer and transplant care,” Dr. Britigan said. “That has to continue. In addition, we will improve our quality. Our goal is to be in the 90th percentile nationally in patient satisfaction.”
- Operate in an efficient manner that is aligned with payment levels
“We will be paid less for the services we provide – that’s happening now,” Dinsmoor said. “To close that gap, we aim to achieve significant margin improvement. But I see that more as an outcome than a goal. If we do all these things correctly, the financial part will take care of itself.
“When you’re three different organizations, patients get different bills from the physicians and the hospital. The goal is for that to go away, and there will be a much more seamless and responsive entity that patients and physicians will deal with.”
- Manage patients’ health throughout their lives
“There’s an increased focus on outpatient care, preventing illness instead of just treating it.” Dr. Britigan said. “Our organization will bring together experts in all areas: general medicine, specialists, hospital care and even home care.”
- Synergy among clinical, education and research missions
The organizational goal is to increase student and resident satisfaction to 90 percent in the areas of learning environment and experience; and to increase the number of teaching opportunities in ambulatory settings by 50 percent.
Dr. Britigan said that the educational and research missions that have been so important to the medical center’s success will flourish in the newly integrated organization.
“What makes UNMC and The Nebraska Medical Center unique is the availability of cutting edge research to apply to patient care as well as the ability to train the next generation of health care providers,” he said.
“We can see how this change will help our patients and the entire organization,” said Paulette Davidson, CEO of Bellevue Medical Center. “It makes sense for all of us to work together and align our priorities. We’ll be able to operate more efficiently and in the process, improve the patient experience.”
Work on the new organizational alignment began several years ago, when leadership in the hospitals, clinic and educational areas foresaw the changes coming in health care. In early 2013, work groups were formed to come up with specific plans and recommendations for making the newly aligned enterprise a reality.
Physicians and administrators worked together on a project known internally as OneTeam at the medical center. A series of employee forums for members of all medical center institutions have been held throughout the year with the goal of keeping employees informed of the work involved in integrating the parts of the medical center that have traditionally been separate.
“The outside world doesn’t see us as multiple or different entities, they see us as ‘the med center,’” said Cory Shaw, CEO of UNMC Physicians. “Our patients don’t notice if our employees are wearing a Bellevue Medical Center badge, The Nebraska Medical Center badge or a UNMC Physicians badge. All they’re concerned about is getting the care they need.”
Questions posed by hospital and clinic employees have centered on whether there would be job cuts as a result of the integration.
“We’ve been very open with everyone,” Dinsmoor said. “It is possible, but the truth right now is that we don’t know what the impact will be. A very likely scenario would be one where people in one area of health care are learning a new skill and working in a different area – perhaps transitioning from inpatient care to outpatient care.”
“I have every confidence that bringing our organizations together is the right thing to do,” said Harris Frankel, M.D., UNMC assistant professor of neurological sciences and director of general neurology. “It will, without question, position us to be a successful academic health science center in the era of health care delivery and payment reform.”