Integrated MCG under examination

Hospital, health system, physicians meeting weekly to devise plan
MCG President Ricardo Azziz would serve as chairman of the new board.

As state leaders look at models for creating a new system that integrates Medical College of Georgia, its health system and physician groups under the incoming president of MCG, leaders from all three areas are meeting regularly to better coordinate what they do and look at sharing some services.


Becoming more integrated will better position them for health insurance reforms, said MCG School of Medicine Dean D. Douglas Miller.

The University System of Georgia Board of Regents revealed preliminary plans to bring the boards of MCG Health Inc., which runs the school's clinical system, and of Physicians Practice Group under the authority of a new MCG Health System Inc. board chaired by new MCG President Ricardo Azziz. The two boards would continue, however, and retain assets and capital, as both have outstanding bonds issued.

Regent Felton Jenkins, who is chairing the ad hoc committee looking at the reorganization, cautioned it is a work in progress.

"We are maybe 40 percent down the road, maybe 50 percent," he said. The committee is working with a consultant, The Chartis Group, and is trying to meld two of the four options the group suggested.

The 10-year lease, by which MCG Health Inc. operated the clinical system through joint agreements with the school and PPG, is up in July and the regents want to get a new agreement in place before then. Almost from the very beginning, the parties have been at odds over what MCG Health Inc. would pay the school and PPG for various services, disputes that often dragged on for months.

"The system that was set up 10 years ago or so hasn't worked as smoothly as everyone had hoped," Jenkins said. "Maybe there were personality conflicts. The present system doesn't give the (MCG) president as much control as he needs."

The ad hoc committee has been working with Azziz on the new model "and he's comfortable with it," Jenkins said.

A five-member "Integrative Management Team" with leaders from all three segments went to work in late October and quickly resolved some of the outstanding issues, Miller said. It has been meeting almost weekly since then to bring things closer together, he said. Integration of services is being pushed by national groups such as the Association of American Medical Colleges as a way to respond to coming reforms, Miller said.

"Health care insurance and reimbursement will be significantly tied to efficiencies and delivery of care models that are integrated," he said. "Their advice at a national level has been to integrate leadership and to try to develop a strategic integration focus that would be a proper response to health care insurance reform."

New payments might be bundled, for instance, with a single payment that must be split between physician and hospital. The integrative team is also looking at what services could be shared among the three, Miller said. Other institutions share IT services, for instance, or purchasing.

"All of those things could be viewed as opportunities for a shared services agreement," he said. "We're certainly going to be looking very closely for efficiencies and additional efficacy so we can optimize our care model and provide better care to even more patients in this area."