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Health Centers' Financial Woes Continue, Report Says
Although they survived the initial period of rapid change in the U.S. health care system, academic health centers still face long-term financial problems, according to the Commonwealth Fund's Task Force on Academic Health Centers. Issued last February, Envisioning the Future of Academic Health Centers is the final report of the task force, which was created in 1995 and has issued several previous reports. Academic health centers, including medical schools and their associated facilities, have traditionally focused on education and research, specialized health care services, and care for poor and uninsured patients.
The report's authors say that many people see less need to examine the social role of academic health centers and their sources of support since the "retreat" of managed care and the relative success of efforts to temper Medicare cutbacks in the past few years. The authors disagree with this perception, however, noting the instability of the U.S. health care system, which is experiencing double-digit cost inflation and perhaps "spiraling toward crisis." Reactions to rising costs and concerns about access to and quality of care will present academic health centers with new challenges, they say, arguing that the current funding structure is untenable and should be reformed. Academic health centers offer more specialized services than do other hospitals, and treat more "medically vulnerable" patients who need rare, complex, or innovative services not readily available elsewhere. In the past, the centers often subsidized such treatment with earnings from routine patient care, but increased competition in the health care market has reduced charges for routine care.
The task force makes several recommendations for the academic health center community and for public policy. Among other measures, it suggests that the centers need to "dramatically improve their internal accounting capabilities," and that a larger proportion of their funding should come from the federal government.
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