University Times

How exactly do Pitt's six Health Sciences schools fit in — financially and structurally — with the rest of the University and with the University of Pittsburgh Medical Center (UPMC)? To answer that question, the Board of Trustees health sciences committee plans to prepare a "white paper" report with help from UPMC administrators and Ernst and Young accountants.

Committee members plan to discuss the project during a closed-door meeting following the Feb. 22 public meeting of the full board.

"What we envision is a fact-based document. It won't make recommendations and it should be fairly non-controversial," said trustee Karen Fisher, who has chaired the health sciences committee since April 1994.

"The goal is to give the board and the University community a sense of what the current structure is between the Health Sciences schools, UPMC and the rest of the University. There seems to be a fair amount of confusion on campus about what those relationships really are," Fisher said.

The report will identify the schools' sources of income and expenditures, including revenues they receive from UPMC hospitals, she said. "It's important for the trustees to know exactly what the financial relationship is between those schools and UPMC." The white paper will be released to the public and could be a starting point for discussions among Pitt trustees about the future of the Pitt-UPMC relationship, said board chairperson J. Wray Connolly.

"It may be that the relationship is fine the way it is," Connolly emphasized. "But you can't even begin to talk about changes until you define what the current arrangement is. I would say the purpose of this committee report is to clear the decks of misunderstandings and misinformation. Then we can decide what we ought to do.

"One of the problems that exists with respect to the whole upper and lower campus debate, or friction, is a lack of understanding relative to the organizations," Connolly said.

One source of that misunderstanding, he pointed out, is the existence of three different UPMCs: * The UPMC Division, a division of the University that is responsible for the fiscal, administrative and clinical components of Pitt's School of Medicine and its practice plans.

* The University of Pittsburgh Medical Center System (UPMCS), the parent corporation for Presbyterian University, Montefiore University, and Eye and Ear hospitals. UPMCS is a separate corporation outside the University. Pitt does not own the UPMC hospitals.

* The various components of Pitt's academic medical center that are referred to collectively as UPMC. This includes the medical school and some programs at the five other Health Sciences schools.

Some Pitt professors have wondered aloud, at Faculty Assembly meetings and elsewhere, whether the proliferation of UPMCs wasn't a ploy by certain Pitt and Presby administrators to blur boundaries between the hospitals and the University. Prior to 1990, the UPMC Division was called the Medical and Health Care Division. UPMCS had been called the Presbyterian University Hospital System, Inc., prior to 1993, when Montefiore University Hospital was merged into Presby.

According to Connolly, some of the resentment that lower campus personnel express toward "the Pitt medical center" is ill-founded because it actually refers to policies of UPMCS, which is not part of Pitt.

UPMC figured into the one factual error in the first draft of the study by outside experts who recently evaluated the University, Connolly noted. (See story beginning on page 1.) "Interestingly, only one change had to be made in the first draft of that report. They [the consultants] had gotten the relationship wrong between UPMC and Pitt," the board chairperson said.

If the health sciences committee of Pitt's own Board of Trustees doesn't fully grasp the Pitt-UPMC relationship, doesn't that support recent criticism of the trustees as being ill-informed? Committee chairperson Fisher replied: "I think that's a fair question. But I also think that the members of our committee already have a pretty good understanding of the relationship. In the future, though, the board will have to gain a deeper understanding of the nuts and bolts of what's going on [in the Health Sciences schools and UPMC], in light of the rapid changes occurring in the health care field." Fisher is general counsel for the Prospective Payment Assessment Commission, a Washington, D.C.,-based federal advisory commission on Medicare payment policy.

— Bruce Steele