Medical school funding, Vidant discussed at trustees meeting
Friday, July 12, 2019
The Brody School of Medicine is “quite underfunded” by Vidant Medical Center, the vice chancellor of health sciences said during a Thursday orientation session for East Carolina University’s Board of Trustees.
Dr. Mark Stacy, vice chancellor of ECU Division of Health Sciences and medical school dean, said he wants to see a a better relationship and a better balance of power between the medical school and Vidant Health.
“When I have to go and say, ‘Give me more money, give me more money,’ we don’t get to talk about things that are really important,” Stacy said, such as developing a telemedicine program to improve health care service in underserved areas.
A telemedicine program could help a 14-year-old contemplating their first sexual experience find information and resources to help avoid an unwanted pregnancy, he said.
Stacy’s comments were in response to questions newly appointed trustee Tom Furr had about the relationship between the medical school and Vidant Health and how it compared to UNC Health Care and the University of North Carolina School of Medicine.
Thursday’s meeting was an orientation session for the 13-member Board of Trustees, which is starting the 2019-20 fiscal year with five new members.
Furr said he wants to learn about Brody’s relationship with Vidant and how it compares to the UNC Health. He said he was told the UNC medical school receives a $150 million payment from the UNC hospital but Vidant’s payment to Brody was only a third of that amount.
Stacy explained the UNC payment is a mission payment, which is an investment in the education and research efforts of a medical school. It is given in addition to payments for clinical services provided by faculty in the hospital.
ECU does not receive a mission payment from Vidant, Stacy said. The hospital and medical school have 156 contracts that outline the services Brody faculty and physicians provide the hospital.
Collectively those contracts pay Brody about $52 million annually, Stacy said. However, many of the contracts date back to 2009 and the reimbursement rates need updating.
Stacy said if the reimbursement rates were updated to 2018 levels, the medical school would get an additional $10.7 million from Vidant.
“As a board you can help me by going to the Vidant Board and saying, “How come you aren’t letting Mark just get to 2018 rates?’ That is something they can do with a vote,” Stacy said. “We can renavigate the other planks of that contract.”
Stacy also discussed the imbalance between reimbursement rates received by medical practices versus hospitals.
Reimbursement rates for doctors and physician practices, such at ECU Physicians, has declined during the last 20 years while reimbursement to hospitals for procedures conducted by physicians in the hospital have increased.
“We’ve seen a change in the way funds flow,” Stacy said.
In the UNC system, the imbalance is corrected because the hospital and medical school are under one umbrella.
“It makes it easier to equilibrate funding and make sure physician practices are paid,” Stacy said.
Since Vidant Health is a private nonprofit and not part of the medical school, revenues generated by procedures performed there stay with the hospital.
“That’s the way it works,” Stacy said.
Furr’s questions and Stacy’s comments come in the middle of a mediation effort brought about when UNC and ECU sued Vidant Medical Center and the Pitt County Board of Commissioners after the two entities voted to stop the UNC Board of Governors from nominating members to the hospital’s board of trustees.
Furr said his questions have no connection to the lawsuit.
“I am trying to learn, since I am a new board member, about how things work,” Furr said in a later interview.
“I believe if a hospital wants to take advantage of a medical school they should consider giving a mission payment because it should benefit everyone,” Furr said. “That’s how our med school gets better, by getting support from folks we send doctors to once they graduate. That’s the way every other traditional academic system works.”
The medical also needs to revise its relationship with ECU Physicians, Stacy said. About 50 percent of Brody School of Medicine’s revenue comes from ECU Physicians. The national median is 36 percent. Stacy’s goal is to reduce that to 41 percent.
The more revenue ECU Physicians can retain, the more care it can provide in the region, Stacy said.
Vidant provides 16 percent of the medical school’s revenue. The national median is 22 percent and Stacy wants to increase Vidant’s provision to 20 percent.