KU Hospital affiliation
- Legislative Post-Audit report addresses questions on both institutions (10-31-07)
- KU Hospital, Med Center tensions diminish (10-31-07)
- Regents seem pleased after KUMC talks (09-18-07)
- KUMC closer to agreement with St. Luke's (09-12-07)
- Chat with KU Chancellor Robert Hemenway (09-10-07)
- No timeline set for hospital affiliation deal (08-11-07)
Kansas University Medical Center leaders say progress has been made to reach agreement on affiliations with various hospitals, but some of the most significant, and most difficult, negotiations still remain.
So far, KUMC has reached agreement with St. Luke's Hospital as far as the research and teaching that will go on. It has also reached agreement on basic guiding principles as far as how St. Luke's would operate within a KUMC cancer center.
But what remains undecided is how Kansas University Hospital, KUMC's primary teaching hospital, and KUMC will work together in a KU cancer center, as well as how KUMC will fit in with a National Cancer Institute, should the medical center receive such a designation.
"We're making very, very good progress," said KUMC spokeswoman Amy Jordan-Wooden. "Optimism is high that we can get this completed."
KU Hospital spokesman Dennis McCulloch agreed, saying that the current goal "is to get it right. If you rush to meet an artificial deadline, it will set back cooperation."
A sticking point
The seeds for the contentious negotiations between KUMC and KU Hospital were sown long ago. Some KU Hospital leaders will admit, privately, that their support for the university remained too low for too long. And hospital leaders point to a decision by the university more than a decade ago as one of the key reasons that cancer programs, while of paramount importance, remain a stumbling block to agreement.
In the 1990s, KUMC outsourced its outpatient cancer program to a third party. The agreement was for 35 years and did not include an escape clause.
When the KU Hospital Authority was created, it spent $17 million to bring the cancer program back in house.
"Getting that program back required a lot of tough negotiation," said Jeff Wright, KU Hospital's executive director of cancer services.
Since then, the hospital has invested $80 million in equipment, space and technology, including a new outpatient cancer clinic.
Because of the money spent, KU Hospital is reluctant to loosen its grip on the KU Cancer Center brand, which KU Hospital created, in a way that would help a competitor, like St. Luke's Hospital.
What KU wants
Though KU leaders have said KU could use the Midwest Cancer Alliance name, it would clearly prefer to operate a cancer program branded with the university.
The university has said that achieving NCI designation is the No. 1 goal, among other reasons, because it would improve KUMC and KU Hospital's ability to provide patient care, Jordan-Wooden said.
"We have to break down traditional barriers in order to compete on the national stage," Jordan-Wooden said. "Roy (Jensen, director of the KU Cancer Research Institute) has been talking with Bob Page, Roy has been talking with Richard Hastings, Roy's been talking to a lot of people."
Page is the president and CEO of KU Hospital and Hastings is the president and CEO of St. Luke's Hospital.
KU Hospital leaders agree. They want KUMC to get NCI designation - only universities are eligible - but they're hesitant to loosen their control or to share this designation with St. Luke's Hospital as their leaders have demanded.
A possible model
KUMC has indicated its desire to build a cancer center that uses a number of hospitals for its clinical trials.
"For a state like Kansas and an area like the Midwest, we think that's the model we need," Jordan-Wooden said. "Many people don't have the luxury of traveling to an M.D. Anderson or Mayo Clinic," referring to centers in Houston and Rochester, Minn.
In the network model, clinical trials could perhaps be offered at Stormont-Vail Regional Health Center in Topeka, Via Christi in Wichita and perhaps other hospitals around the state.
In briefing the Kansas Board of Regents in September, KUMC Executive Vice Chancellor Barbara Atkinson mentioned the Cancer Institute of New Jersey as an interesting model. While Jordan-Wooden wouldn't say it was KUMC's preferred model, McCulloch and Wright made clear that they liked the New Jersey system.
In New Jersey, there is one flagship hospital and about 15 other hospitals that work as affiliates and offer clinical trials. In the case of KUMC, KU Hospital would be the flagship hospital.
A master affiliation
In addition to the cancer affiliation, KUMC and the hospital must reach agreement on their master affiliation.
"The master affiliation covers everything under the sun," Jordan-Wooden said. "Everything from maintenance to parking to public relations. Way back when, there were 100 issues where we were not on the same page. We've worked our way down to a handful, perhaps less than 10."
Last month, KU Chancellor Robert Hemenway said that KUMC and KU Hospital had reached the point where they were exchanging drafts. Since then, both KUMC and KU Hospital have backed away from that, but McCulloch said that certain parts of the affiliation have been forwarded on to the lawyers for drafting. He cited the agreement to increase the amount of unrestricted mission support as one of those areas. There is also agreement to increase the number of residents trained at KU Hospital.
Other issues, like the cancer center and how physicians will be compensated, remain to be determined.
But there is hope. At the KU Hospital Authority meeting Tuesday, Charlie Sunderland, chairman of the authority's master affiliation task force, said there could be workable drafts available by December.
"In the not too distant future, the legal teams will get involved," he said. "This will be a very good agreement that will strengthen the relationship between the hospital and the School of Medicine.