The AMC Journey to a Delivery Model of the Future

Academic medical centers (AMCs) across the U.S. are facing the brunt reality of changing times.

Let’s be frank: AMCs’ business framework is under siege. Healthcare payers, employers, and consumers are no longer willing to absorb the steep costs built into our traditional delivery models. AMCs, therefore, face a tall but critical order: we must embrace the mounting pressures to provide value-based and cost-efficient care by reconfiguring the very way we run as organizations.

As the Chief Operating Officer of the Clinical Practice Organization at UC San Diego Health, I tell you this from experience. I’ve been down this road and am thrilled to share what I’ve learned in priming my AMC to face the future on a steady and sustainable foundation.

UC San Diego Health was established in 1966. We consistently rank high in delivering on our educational mission and the clinical care we provide our patients. We’re associated with a preeminent medical school and have a rich history as a national research institution.

But despite our accolades, we hold only a 10 percent share of the inpatient market, and our faculty provides only three percent of our area’s outpatient visits. In addition, we’re often left out of networks due to the higher cost of our services.

To remain viable and competitive, we faced an ultimatum. We could transition to a high-performing, clinically integrated, and team-based delivery model, while still providing the quality care we’ve long been known for, or we could refuse to change and suffer the consequences. This experience isn’t unique. All AMCs—among other medical groups—will confront this crossroad. But I believe that if we all work together, we can transform our organizations to meet the needs of our patients and communities while succeeding financially.

AMCs have extraordinary resources. We are known for our high-quality care, our stellar local and national reputations, and our strong track record of educating and training some of the nation’s best and brightest physicians. By harnessing these attributes, we can transform how we operate, without forgoing the cutting-edge patient care, education, and research we provide. To be successful, AMCs like mine must become highly integrated, efficient, and nimble. We need to be organizations of the future, and we will do it by adapting processes to meet today’s expectations and tomorrow’s challenges. The journey will undoubtedly be long, but it’s one that is unavoidable.

During AMGA’s annual conference, I will lead a session on UC San Diego Health’s transformation and the journey toward value-based care. I will discuss UC San Diego Health’s development of a transformation roadmap—one that your organizations can adapt—as we transitioned to a revamped organizational model that includes primary care, ambulatory and outpatient facility plans. I will share how to establish a business system that accounts for external realities while still preserving the mission of delivering outstanding patient care. And, of course, we’ll talk about recommendations for addressing shrinking funding sources and shifts in governance, lean process improvement, and strategic planning approaches.

I look forward to sharing my experiences and am eager to exchange ideas with others who are facing similar issues.