Clinical Integration

The University of Kansas Medical Center, The University of Kansas Hospital and The University of Kansas Physicians are working to formally establish a new, more integrated clinical enterprise and to benefit medical education. These three entities, along with 18 medical foundations (the clinical departments) work toward a clinical partnership to enhance health care delivery. 

This page will update the campus community on the status of these efforts.

May 2014

May 28: Steve Stites, vice chancellor for clinical affairs, gave a town hall presentation updating the campus on the status of clinical integration.

View the slides.
View the video.

Work groups established

The following groups have been formed to focus on specific aspects of the project. Groups will make recommendations to the principals for adoption. Principals are: Bob Page, Bill Marting, Tammy Peterman, Jim Albertson, Kirk Benson, Lowell Tilzer, Doug Girod, David Vranicar, and Steve Stites, with support from ECG (Chris Collins) and legal representatives ad hoc.

1. All groups report up to the principals.
2. Leads of each group are responsible for setting the agenda and organizing any documents or information for the workgroup.
3. Timelines are from the date of starting the focus question(s) in the workgroup.
4. Workgroups may develop further questions and recommendations as approved by the leads.
5. The administrative assistants of the leads will help organize the groups and take minutes; where there is more than one lead, the assistant to the first person will be the support person. Overall support and coordination will be provided by Allison Madden to try and avoid conflicts where possible.
6. Scheduling priorities will be given to the leads and to other required members; general members will be invited.
7. Committee leads may bring in other members and/or break in to subgroups to help with specific focus questions at their discretion.
8. Project manager has been identified to help with agenda, notes, documents, and reporting; this person will support the different workgroups and help maintain a timeline and update principals on progress.
9. Results will be relayed back to the principals group by the principals on the workgroup and by written response to each focus question.
10. Leads are expected to work together and develop plans and information to bring back to the workgroup; the meetings should be about responding to prepared information.
11. Leads may add other members for specific questions or as required with approval from the principals on the workgroup.

1) Chairs Pool

a) Focus: 
i) Determine metric by which chairs should be compensated from all sources as we have historical data and need to determine FMV and criteria for payment.
ii) Determine the funding for the clinical service chief role and the administrative caps for both the University and clinical portions of the job.
iii) Consider wRVU expectations for chairs.

b) Organization:

Lead(s) Clay Tellers
Other required members   Bill Marting, Rob Simari, Steve Stites, David Vranicar
Other members Jim Albertson, Chris Collins, Scott Helt, Hinano DeBarthe                                                                                        
Timeline 6 weeks



 2) Collections and Cost-Sharing and Non-competes and Physician Employment Agreements

a) Focus: 
i) Determine the collection % formula and how this can affect PSA dollars to a Department in both a positive and a negative manner; or develop an alternative mechanism addressing how departments and the health system both share risk and gain?
ii) Cost: Develop mechanism by which physicians can help manage costs in the health system both in an ambulatory and inpatient environment and share risk and gain relative to variance.
iii) Make recommendations for non-competes and restraint of trade concerns in the new health system.

b) Organization:

Lead(s) Jim Albertson, Bill Marting
Other required members  Scott Helt
Other members Kirk Benson, Doug Burton, Mark Wiley, Chris Hansen, Phil Johnson, Dan Peters, Lowell Tilzer, Terry Tsue, Chris Collins, Steve Stites
Timeline 4, 8 and 12 weeks



 3) PSA and Benefits

a) Focus:
i) Analyze retirement plan and contribution issues and bring back suggested plan to principals.
ii) Evaluate PSA types and vet with departments to account for each type (in progress).
iii) Review and determine outcomes for all liabilities and leases and equipment.
iv) Evaluate placement of NP, PA in terms of placement in UKP or the Health System
v) Physician costs: Work though the cost of benefits and university and health system ownership, especially around the first 12,500 and how the university and health system will share the costs currently and going forward.
vi) Recommend any specific phase-in period for the PSA to be tied with the university reallocation model. 

b) Organization:

Lead(s) Jim Albertson, David Vranicar (for questions 4 and 5)
Other required members  Scott Helt, Steve Stites
Other members Dustin Carrillo, Chris Collins, Chris Hansen, Bill Marting, Dan Peters, Lowell Tilzer, David Vranicar, Kirk Benson, Hinando DeBarthe (questions 4 and 5)
Timeline 8 weeks (1, 2, 3 and 4); 12 weeks (5 and 6)



 4) Space, services billing, reallocation model, and other final frontiers

a) Focus: 
i) Review university cost and funds allocation model with Jim Albertson, Kirk Benson, and Bill Marting.
ii) Space: Evaluate an approach to space and distribution formula for physicians and staff respecting the different missions and establish a general ledger.
iii) Establish a plan for accounting for allied services such as police, etc.
iv) Evaluate needs for any changes in support models such as the ethics committee.

b) Organization:

Lead(s)  Steffani Webb, Jon Jackson
Other required members Scott Helt, John McDonough
Other members Jim Albertson, Bill Marting, Clay Tellers, David Vranicar, Steve Stites, Teresa Neely, Chris Hansen                   
Timeline 4 weeks (1); 8 weeks (2-4)


5) HR Transition and Staff who support both University and Hospital (will also be reviewed in new ambulatory organization workgroup)

a) Focus: 
i) Determine issues and recommendations regarding transition of KUPI employees to health system employees and UKP employees to the university or other entity.
ii) Transition plan: Work on transition plan for employees.
iii) Establish salary and benefits bands for transfer of employees.
iv) Identify staff who support both the university and the system, provide recommendation of best employer model, will account for and employ senior administrators in departments and in GME; need to specifically determine how the senior administrators will be paid and how the university and system will account for their time and comp; should there be single employment or dual?

b) Organization:

Lead(s)  Ruth Pullins, Alisa Ford, David Vranicar
Other required members  Jim Albertson, Bill Marting
Other members  Dustin Carrillo, Doug Girod, Lisa Hoebelheinrich, Teresa Neely, Lori Roop, Suzanne Scott, Tammy Shepherd, Steve Stites, Lowell Tilzer, Dan Peters, Adrian Fitzmaurice, Abe Teferra, Trish Miller
Timeline 8 weeks



6) GME resident salary and education issues for learners and CE

a) Focus:
i) Determine changes and timeline for implementation to resident salaries.
ii) Review and determine implementation plan for LCME and ACGME requirements, including student requirements for EHR, workflow, etc.
iii) Evaluate possible opportunities in CE.
iv) Develop recommendations for changes to GMEC governance structure.

b) Organization:

Lead(s) Steve Stites, Greg Unruh
Other required members Glen Cox, Doug Girod, Jon Jackson
Other members Lisa Hoebelheinrich, Lee Norman, Lori Roop, Clay Tellers, Mark Meyers, Dan Peters, Robert Simari                    
Timeline 6 weeks


7) Malpractice Eligibility

a) Focus: 
i) Determine rules around malpractice eligibility for physicians in new UKP.
ii) Evaluate potential for MAC and hospital employed physicians to come under stabilization fund.
iii) Recommend model for physicians who may be outside of stabilization fund to receive malpractice insurance (may include faculty who are Missouri residents and those who practice off-site in entirely clinical roles without any academic culture).

b) Organization:

Lead(s) Lisa Hoebelheinrich, Dan Peters
Other required members
Other members Jim Albertson, Kirk Benson, Doug Girod, Debby Jackson, Steve Stites, David Vranicar, Dustin Carrillo, Tom McMahon                 
Timeline 8 weeks


8) Research Funding in the Health System

a) Focus:  
i) Determine the costs that are in UKP budgets that are really research costs (coordinators, equipment, etc.) or academic costs.
ii) Recommend assignment of research costs in the new Health System and University Reallocation model
iv) Identify costs to the University that are not currently held from transition of costs out of UKP

b) Organization: Hinano DeBarthe should work with Susan Brisch and Keith Baskin to prepare information for the committee members

Lead(s) Rob Simari, Bill Marting
Other required members   Jon Jackson, Hinano DeBarthe
Other members Jim Albertson, Rick Barohn, Dustin Carrillo, Dan Harrison, Lisa Hoebelheinrich, Dan Peters, Ruth Pullins, Suzanne Scott, Steve Stites, Clay Tellers, Paul Terranova, Marilyn Rymer, Roy Jensen, Adrian Fitzmaurice
Timeline 8 weeks



9) Mission Support

a) Focus:  
i) Determine the funds flow and metric for mission support
ii) Consider discussion on any changes to fund-raising agreements

b) Organization:

Lead(s) Doug Girod, Bob Page
Other required members Bill Marting, David Vranicar
Other members Chris Collins, Clay Tellers, Rob Simari                                                                                                                     
Timeline 12 weeks



10) "Truth and Reconciliation" Committee

a) Focus:
i) Reconcile all the rest we have not yet thought about or not otherwise assigned both now and in going forward in the system.

b) Organization:

Lead(s) Bill Marting, Steve Stites
Other required members Jim Albertson
Members Kirk Benson, Scott Helt, Lisa Hoebelheinrich, Phil Johnson, Tammy Peterman, Dan Peters, Lowell Tilzer, David Vranicar, Brant Thrasher
Timeline Infinity



11) Revenue Cycle

a) Focus: 
i) Make recommendations regarding revenue cycle issues and determine plan going forward in integrated system

b) Organization:

Lead(s) Jim Albertson, Bill Marting
Other required members Colette Lasack, Suzanne Scott, Tammy Shepherd, Barbara Timberlake, Kirk Benson                                                
Other members Chris Hansen, Bill Marting, Teresa Neely
Timeline 12 weeks



12) Evaluate General Ledger and Financial Reporting

a) Focus:
i) Evaluate general ledger and financial issues for the new health system

b) Organization:

Lead(s) Bill Marting, Jim Albertson
Other required members Ken Shipley, Susan Brisch
Other members Brenda Lowe, Tammy Shepherd, Keith Baskin, Scott Helt                                                              
Timeline 12 weeks



13) IT

a) Focus:
i) IT: Evaluate IT needs and workflow in the new health system, especially as physicians and staff transfer out of departments and UKP.
ii) Establish a plan for new workflows as the foundations wind down and UKP employment shifts, especially on Outlook, 02, servers, webpages, and other issues.

b) Organization:

Lead(s) Chris Hansen, Mike Harmelink
Other required members Greg Ator, Teresa Neely, Sean Roberts
Other members Dawn Walters, Steffani Webb, Aroop Pal, Lowell Tilzer, Brian Weiford                                                                  
Timeline 8 weeks



14) Marketing and Branding

a) Focus: 
i) Establish principles around branding and marketing in the new enterprise including use of marks, physician websites, and system approach for budgeting marketing.

b) Organization:

Lead(s) Jon Jackson, Lisa Hoebelheinrich
Required members  C.J. Janovy, Ruth Pullins, Richard Korentager
Other members Brenda Dykstra, Doug Girod, Dan Peters, Ryan Spaulding, Steve Stites, Jim Albertson, John Sutphin, Carl Weiner, Amy Metcalf, Tammy Peterman, Jeff Reene
Timeline 8 weeks



15) Grievance Process and ECMS: 

a) Focus:
i) Develop grievance process outlined in the Department of Medicine with Lathrop and Gage for the new UKP.
ii) Evaluate ECMS and Med Staff policies to consolidate as possible with new UKP especially in hiring, privileges, etc., but keeping c/w JCAHO.

b) Organization:

Lead(s) Lee Norman, Lou Wetzel
Other required members Amy Ladner, Dan Peters
Other members Mike Artman, Micki Davis, Talal Khan, Tammy Peterman, Amy Sokol, Steve Stites, Lowell Tilzer, Marla Wilson, Melissa Parkhurst, Tom McMahon, Vice Chief of Staff (election pending), Ruth Pullins, Doug Burton, Bill Gabrielli
Timeline 12 weeks



16) Risk Management: 

a) Focus:
i) Outline a strong risk management process for the new health system and employees.

b) Organization:

Lead(s) Dan Peters, Amy Sokol
Other required members Lou Wetzel, Lee Norman
Other members Monica Lubeck, Tim Williamson, Debby Jackson, Tom McMahon, Lisa Hoebelheinrich, Micki Davis, Venus Buckner
Timeline 12 weeks


17) Regulatory and Joint Commission

a) Focus:
i) Ensure compliance with JC and other regulatory requirements throughout new health system.
ii) Evaluate the impact of the planned conversion of UKP practices to provider based in the new health system.

b) Organization:

Lead(s) Liz Carlton, Teresa Neely
Other required members  Monica Lubeck, Dan Peters, Amber Styles, Micki Davis
Other members Sally Enevoldson, Lee Norman, Amy Sokol, Steve Stites, Reta Studnicka, Lou Wetzel, Tim Williamson, Suzanne Scott, Dustin Carrillo, Donamae Rebman, Tammy Peterman
Timeline 12 weeks



18) Nursing

a) Focus:
i) Develop nursing practice model.
ii) Evaluate impact on Magnet status to ensure meeting of requirements by the new health system.

b) Organization:

Lead(s) Tammy Peterman, Chris Ruder
Other required members Teresa Neely, Rachel Pepper, Donamae Rebman, Liz Carlton
Other members Kim Dixon, Alisa Ford, Ruth Pullins, Micki Davis, Cassie Packard                                                                       
Timeline 12 weeks



19) Medical Directors and Clinical Service Chiefs

a) Focus:
i) Recommend any changes to the medical directorship program.
ii) Look for opportunities in medical directors and clinical service chief functions to help drive performance in the new health system (note that funding of CSC is under the chairs working group).

b) Organization:

Lead(s) Steve Stites, Tammy Peterman
Other required members Greg Ator, Cathy Gardner
Other members Bill Marting, Scott Helt, Lee Norman, Tim Williamson, Chris Collins, Lowell Tilzer                                            
Timeline 12 weeks


20) Communications

a) Focus:
i) Determine appropriate communication strategies and schedule updates and town halls, etc., to disseminate information regarding integration with providers, employees, the campus and the community.

b) Organization:

Lead(s) C.J. Janovy, Sharon Robinson, Ruth Pullins
Other required members
Other members Amy Metcalf, Ryan Spaulding, Steve Stites, Dennis McCulloch, Brenda Dykstra, Dustin Carillo, Suzanne Scott                          
Timeline 4 weeks


21) Recruitment

a) Focus:
i) Establish process for recruitment of new providers in to the health system.

b) Organization:

Lead(s) Brenda Dykstra, Steve Stites
Other required members
Other members Jim Albertson, Mike Artman, Rick Barohn, Dustin Carrillo, Hinano DeBarthe, Scott Helt, Bill Marting, Tammy Peterman, Ruth Pullins, Suzanne Scott, Rob Simari, David Vranicar, Carl Weiner, Susan Brisch
Timeline 8 weeks



22)  New Ambulatory Organization

a) Focus: 
i) Establish operational and management principles for ambulatory operations in the new health system.
ii) Establish a process for space management in the MOB and throughout the health system.
iii) Determine cost allocation to clinical programs for space allocation to encourage efficient use of space.
iv) Shape roles for ambulatory leaders in the new health system.
v) Establish mechanisms around bringing community practices in to the heath system.

b) Organization:

Lead(s) Steve Stites, Tammy Peterman
Other required members Chris Hansen, Teresa Neely
Other members Jim Albertson, Eyad Al Hihi, Doug Burton, Dustin Carrillo, Micki Davis,  Brenda Dykstra, Josh Freeman, Carrie Jordan, Talal Khan, Steve Lauer, Bill Marting, Brant Thrasher, Terry Tsue, Mark Wiley, Bruce Toby, Mark Myron, Carl Weiner
Timeline 8 weeks



23)  Hospital Based Operations

a) Focus: 
i) Establish operations for new hospital based integrated departments.
ii) Establish organizational structure and management plan for hospital based departments.

b) Organization:

Lead(s)  Tammy Peterman, Phil Johnson
Members Jim Albertson, Chris Hansen, Talal Khan, Bill Marting, Patricia Sanders-Hall, Steve Stites, Lowell Tilzer, Lila Martin, Chris Ruder
Timeline 6 weeks

Last modified: Jun 12, 2014