Health System Creation and Integration at a Health Sciences University: A Five-Year Follow-up

Catherine P Slade, Ricardo Azziz, Steven Levin, Gretchen B Caughman, David S. Hefner, Kimberly Vess Loomer, Martha S Tingen, Susan James

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Shifting healthcare market forces and regulation have exerted near-constant pressure on U.S. academic health centers (AHCs) attempting to successfully execute their traditional tripartite mission. A governance structure and organizational alignment that works well under one set of conditions is rarely optimal when conditions change. Thus, the degree and type of alignment of an AHC's clinical, educational, and faculty practice organizations have changed regularly within the sector, typically landing near one end or the other on a continuum from fully aligned with centralized governance to largely independent with separate governance. The authors examine the case of Georgia Regents University and Health System in this context. In step with industry trends, the institution's governance structure swung from fully aligned/centralized governance in the early 1990s to essentially separate and decentralized by 2000. In 2010, the Georgia Regents University organizations achieved rapid realignment by creating a governance structure of sufficient strength and flexibility to absorb and adjust to continuing external upheaval. The hospitals, clinics, and physician-faculty practice group were combined into one integrated health system, then aligned with the university to form the state's only public AHC under aligned, but distinct, corporate and management structures. The years since reorganization have seen significant growth in patient volumes and complexity, improved service quality, and enhanced faculty physician satisfaction, while also significantly increasing economic contributions from the health system to the academic mission. This case study offers observations and lessons learned that may be useful to other higher education institutions considering reorganization.

Original languageEnglish (US)
Pages (from-to)386-402
Number of pages17
JournalJournal of Healthcare Management
Volume62
Issue number6
DOIs
StatePublished - Nov 1 2017

Fingerprint

Systems Integration
Health
Organizations
Physicians
Health Care Sector
Industry
Public Health
Economics
Education
Pressure
Governance
Governance structure
Growth
Alignment
Reorganization

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Strategy and Management

Cite this

Health System Creation and Integration at a Health Sciences University : A Five-Year Follow-up. / Slade, Catherine P; Azziz, Ricardo; Levin, Steven; Caughman, Gretchen B; Hefner, David S.; Loomer, Kimberly Vess; Tingen, Martha S; James, Susan.

In: Journal of Healthcare Management, Vol. 62, No. 6, 01.11.2017, p. 386-402.

Research output: Contribution to journalArticle

@article{74a3f4cb96d2492b9d71784267a18a09,
title = "Health System Creation and Integration at a Health Sciences University: A Five-Year Follow-up",
abstract = "Shifting healthcare market forces and regulation have exerted near-constant pressure on U.S. academic health centers (AHCs) attempting to successfully execute their traditional tripartite mission. A governance structure and organizational alignment that works well under one set of conditions is rarely optimal when conditions change. Thus, the degree and type of alignment of an AHC's clinical, educational, and faculty practice organizations have changed regularly within the sector, typically landing near one end or the other on a continuum from fully aligned with centralized governance to largely independent with separate governance. The authors examine the case of Georgia Regents University and Health System in this context. In step with industry trends, the institution's governance structure swung from fully aligned/centralized governance in the early 1990s to essentially separate and decentralized by 2000. In 2010, the Georgia Regents University organizations achieved rapid realignment by creating a governance structure of sufficient strength and flexibility to absorb and adjust to continuing external upheaval. The hospitals, clinics, and physician-faculty practice group were combined into one integrated health system, then aligned with the university to form the state's only public AHC under aligned, but distinct, corporate and management structures. The years since reorganization have seen significant growth in patient volumes and complexity, improved service quality, and enhanced faculty physician satisfaction, while also significantly increasing economic contributions from the health system to the academic mission. This case study offers observations and lessons learned that may be useful to other higher education institutions considering reorganization.",
author = "Slade, {Catherine P} and Ricardo Azziz and Steven Levin and Caughman, {Gretchen B} and Hefner, {David S.} and Loomer, {Kimberly Vess} and Tingen, {Martha S} and Susan James",
year = "2017",
month = "11",
day = "1",
doi = "10.1097/JHM-D-16-00007",
language = "English (US)",
volume = "62",
pages = "386--402",
journal = "Journal of Healthcare Management",
issn = "1096-9012",
publisher = "Foundation of the American College of Healthcare Executives",
number = "6",

}

TY - JOUR

T1 - Health System Creation and Integration at a Health Sciences University

T2 - A Five-Year Follow-up

AU - Slade, Catherine P

AU - Azziz, Ricardo

AU - Levin, Steven

AU - Caughman, Gretchen B

AU - Hefner, David S.

AU - Loomer, Kimberly Vess

AU - Tingen, Martha S

AU - James, Susan

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Shifting healthcare market forces and regulation have exerted near-constant pressure on U.S. academic health centers (AHCs) attempting to successfully execute their traditional tripartite mission. A governance structure and organizational alignment that works well under one set of conditions is rarely optimal when conditions change. Thus, the degree and type of alignment of an AHC's clinical, educational, and faculty practice organizations have changed regularly within the sector, typically landing near one end or the other on a continuum from fully aligned with centralized governance to largely independent with separate governance. The authors examine the case of Georgia Regents University and Health System in this context. In step with industry trends, the institution's governance structure swung from fully aligned/centralized governance in the early 1990s to essentially separate and decentralized by 2000. In 2010, the Georgia Regents University organizations achieved rapid realignment by creating a governance structure of sufficient strength and flexibility to absorb and adjust to continuing external upheaval. The hospitals, clinics, and physician-faculty practice group were combined into one integrated health system, then aligned with the university to form the state's only public AHC under aligned, but distinct, corporate and management structures. The years since reorganization have seen significant growth in patient volumes and complexity, improved service quality, and enhanced faculty physician satisfaction, while also significantly increasing economic contributions from the health system to the academic mission. This case study offers observations and lessons learned that may be useful to other higher education institutions considering reorganization.

AB - Shifting healthcare market forces and regulation have exerted near-constant pressure on U.S. academic health centers (AHCs) attempting to successfully execute their traditional tripartite mission. A governance structure and organizational alignment that works well under one set of conditions is rarely optimal when conditions change. Thus, the degree and type of alignment of an AHC's clinical, educational, and faculty practice organizations have changed regularly within the sector, typically landing near one end or the other on a continuum from fully aligned with centralized governance to largely independent with separate governance. The authors examine the case of Georgia Regents University and Health System in this context. In step with industry trends, the institution's governance structure swung from fully aligned/centralized governance in the early 1990s to essentially separate and decentralized by 2000. In 2010, the Georgia Regents University organizations achieved rapid realignment by creating a governance structure of sufficient strength and flexibility to absorb and adjust to continuing external upheaval. The hospitals, clinics, and physician-faculty practice group were combined into one integrated health system, then aligned with the university to form the state's only public AHC under aligned, but distinct, corporate and management structures. The years since reorganization have seen significant growth in patient volumes and complexity, improved service quality, and enhanced faculty physician satisfaction, while also significantly increasing economic contributions from the health system to the academic mission. This case study offers observations and lessons learned that may be useful to other higher education institutions considering reorganization.

UR - http://www.scopus.com/inward/record.url?scp=85034570746&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85034570746&partnerID=8YFLogxK

U2 - 10.1097/JHM-D-16-00007

DO - 10.1097/JHM-D-16-00007

M3 - Article

C2 - 29135763

AN - SCOPUS:85034570746

VL - 62

SP - 386

EP - 402

JO - Journal of Healthcare Management

JF - Journal of Healthcare Management

SN - 1096-9012

IS - 6

ER -