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Agreements define UB, hospital roles
Institutions' responsibilities better outlined
By LOIS BAKER
Contributing Editor
New affiliation agreements that are being negotiated between UB and its teaching hospitals will define and fundamentally change the working relationship between the UB medical school and its teaching hospitals. The agreements are laying the groundwork for improved and more cost-efficient health care in Western New York.
The new agreements between UB and Kaleida Health and UB and the Erie County Medical Center, announced at a press conference on Aug. 21, spell out the roles of the university and the hospitals in the health-care system. In particular, they stipulate that the university will have the responsibility for medical research and educating medical students and residents, while the hospitals will have the responsibility for patient care.
A similar agreement is pending between UB and Roswell Park Cancer Institute (RPCI), and negotiations are under way on agreements between UB and the Veterans Affairs Western New York Healthcare System and UB and the Catholic Hospital System.
Affiliation agreements with these latter two systems are expected to be finalized in 60-90 days, with RPCI's signing anticipated by September.
Michael E. Bernardino, vice president for health affairs and dean of the School of Medicine and Biomedical Sciences, said the agreements are designed to enhance the mission of all parties.
"This new order provides the girders for building a high-quality regional health-care system," Bernardino said. "These new affiliations can set the stage for revolutionizing and revitalizing health-care delivery the relationship between the hospitals and the medical school has been so clearly defined, Bernardino described the development as "a seminal event in the medical school's history, and it promises tremendous rewards for the community."
Bernardino said the agreements could serve as the basis for regional health planning "by helping us strategically plan for academic missions. The community could end up with the best thing of all—rational allocation of health-care resources. Better planning for care will mean better care and more cost-efficient care."
President William R. Greiner said the cooperative effort that led to the new agreements "is a model of collaboration and cooperation that sets a standard for initiatives addressing other community needs. These agreements are yet another example of how UB and its partners strengthen not only their individual institutions, but the future of the entire region, by working together."
Greiner acknowledged the efforts of all participants in UB's negotiations with ECMC and Kaleida Health. "Exceptional contributions were made by Deputy County Executive Bruce Fisher; Sheila Kee, ECMC's chief executive officer, William McGuire, Kaleida's chief executive officer, and UB vice president for health affairs Dr. Michael Bernardino," Greiner added.
"Also playing a key role throughout this process were County Executive Joel Giambra, Robert Wilmers, chairman, president and chief executive officer of M&T Bank Corp., and the other members of the Buffalo Heathcare Task Force appointed by the County Executive who gave momentum to this process, especially Gerald Lippes, member of the UB Council and member and past chair of the Kaleida Health Board of Directors, and Jeremy Jacobs, chair of the University at Buffalo Council."
County Executive Joel A. Giambra noted: "My team worked for months with UB to craft a durable and fair agreement. Today, I am recommending to both the Erie County Legislature and to the Board of Managers of ECMC that we all approve this new affiliation agreement as soon as possible.
"No single health-care institution in this community can ever hope to achieve excellence in isolation," Giambra said. "Our collective health—economic as well as physical—requires that institutions collaborate and plan jointly. This agreement is our historic commitment to that collaboration."
William L. Joyce, president of the Kaleida Health Board of Directors, said the new agreement between Kaleida Health and UB offers many pluses for its acute-care hospitals, which include Buffalo General Hospital, The Children's Hospital of Buffalo, DeGraff Memorial Hospital, Millard Fillmore Gates Circle Hospital and Millard Fillmore Suburban Hospital.
"It cements a very stable relationship with UB and it opens the potential for Kaleida to have more collegial, cooperative relationships with other health-care systems," Joyce added. "It will help improve the quality of care in our institutions, and help make care in our institutions more cost-effective. It also will help our hospitals recruit the highest quality doctors and resident physicians."
Major features of the new affiliation agreements between UB and Kaleida Health and UB and ECMC include:
UB will become the sole sponsor of the training of resident physicians and dentists in all affiliated hospitals, bringing supervision of residency training in line with that of medical schools across the country. The residency programs in Buffalo have been sponsored by the Graduate Medical and Dental Consortium of Buffalo. UB also will assume responsibility for all medical student educational activities that take place in the hospitals.
Hospitals will pay the medical school for the clinical services provided by UB faculty, rather than paying faculty or departments directly. In turn, those funds will be deposited into the respective departmental practice plans, which are managed by UB Associates, a separate non-profit organization.
All research funds generated by UB faculty conducting research in affiliated hospitals—with the exception of Roswell Park Cancer Institute—will be managed by the SUNY Research Foundation or the UB Foundation.
The new affiliation agreements acknowledge the need to ensure that the clinical practice plan of each department supports the medical school's academic programs; to promote faculty collegiality and excellence in teaching, research and clinical activities; to guarantee maintenance of common goals and a common clinical philosophy among the medical school's departments and faculty, and to make sure affiliated hospitals can provide high-quality medical care for patients.
Bernardino and the chief operating officers of affiliated health systems will form the Joint Affiliation Committee (JAC), which will advise the medical school in its academic strategic planning and approve the financial plan for operation of all residency programs. In turn, the JAC will provide the structure under which the hospitals can develop mutually beneficial working relationships.