UC President Convenes Group to Develop Recommendations Regarding Terms of Agreements with Other Health Systems

University of California President Janet Napolitano today announced the launch of a working group to ensure that UC’s values are upheld when its academic health systems collaborate with other health systems.

The Working Group on Comprehensive Access (WGCA) will review common types of health system agreements where patient access to care might be limited due to policy restrictions on services provided, and provide written recommendations to guide future collaborations. The intent is to ensure patients under the care of UC personnel at non-UC facilities have access to a full range of health care services.

The University of California’s health enterprise includes six health systems and 18 health professional programs. UC’s clinical expertise is often sought out by other health care organizations to strengthen or augment clinical capabilities, and UC physicians often provide services at non-UC facilities. UC also operates the largest training program in the state for health professionals. UC’s medical, nursing, pharmacy and public health students, residents, and other trainees broaden their educational and field experience by rotating through a variety of settings, including non-UC facilities.

The WGCA is an outgrowth of recent public debate about the University’s ability to ensure patients receiving care from UC personnel at non-UC facilities retain access to a comprehensive range of clinical services. The University withdrew from negotiations to expand its relationship with another health system earlier this year after concerns were raised that UC had not provided sufficient assurance of non-interference in access to care.

“The vigorous debate around that proposed agreement demonstrated we must do more to ensure UC’s values are embedded in all of our collaborative efforts and to address the concerns that were raised,” said UC President Janet Napolitano. “Our expectation has always been that UC health professionals provide UC-level expertise to all patients, including at health facilities operated by other organizations.”

Affiliations and other health services and training agreements allow UC to serve patients at facilities that are best suited to their care requirements or their geographic location. UC’s medical centers are often full, and agreements enabling UC providers to care for patients at non-UC hospitals and clinics allow more patients to receive UC’s high quality medical care. Additionally, hospitals in underserved areas have difficulty recruiting certain types of providers. Agreements for UC physicians to care for patients in non-UC facilities increase the number of access points in a community, which is important to fulfill the University’s service mission. However, this expanded access must be accompanied by clear expectations that preserve physician autonomy and allow patients to evaluate and choose from all appropriate care options.

The WGCA includes leadership from campuses, medical centers, and the University’s Academic Senate and will consider a broad array of collaboration scenarios – encompassing respect for a diversity of opinions. The group will review concerns raised about patient access in other health systems, as well as UC’s operational, training and patient care needs. The group’s main charge is to develop written recommendations for consideration by President Napolitano regarding the terms under which UC academic health systems will enter into affiliations with other health systems to protect patient access to comprehensive care. The Working Group’s written preliminary recommendations are expected in the fall.

UC has a long-standing expectation that its physicians will remain free to counsel patients about all treatment options, and that patients will have access to comprehensive services. However, the language used in some agreements with other health systems may appear to contradict these expectations. As such, and in parallel to the forward-looking efforts of the Working Group, the University is seeking to amend current agreements to clarify expectations of UC trainees and health professionals when providing care at non-UC health facilities. Additionally, the University has developed interim guidelines that will govern new agreements and renewals of expiring contracts deemed critical to UC's clinical and academic missions.


About UC Health
The University of California’s health enterprise, UC Health, includes six academic medical systems, health professional schools in medicine, nursing, dentistry, optometry, pharmacy, public health and veterinary medicine, clinical oversight of student health and counseling centers, and oversight of self-funded health plans offered to UC employees.