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Academic medical centers provide cutting edge acute care, train tomorrow's physicians, and carry out research that will expand the range of treatable and curable illnesses. But these centers themselves may need urgent care -- experts generally agree that many are suffering acute -- even life-threatening -- financial distress. Many academic medical centers are suffering for several reasons: in-patient admissions are down, as many procedures that once required a hospital stay are now performed on an out-patient basis or in a physician's office; managed care plans have negotiated discounted fees that cut hospital operating margins; the Balanced Budget Act of 1997 curtailed Medicare reimbursements, lowered margins and pushed some into the red; the revolution in information technology is imposing large new capital costs; and the character of medical education is receiving its most thorough review in decades.While there is a general consensus that medical centers are under pressure, experts disagree about the depth and pervasiveness of the current financial distress. Are they whining about financial pressures other, less-favored sectors find routine; or is the high quality American teaching hospital becoming an endangered species -- that could face extinction if nothing is done. Because academic medical centers perform such important jobs, it is critical to determine the true nature and depth of their current financial problems -- and then fashion analytically sound and politically sustainable solutions. This book brings together chief executive officers of major medical centers, university presidents, senior members of Congressional and executive office staffs, and leading analysts. Theseexperts address the key issues and prescribe remedies both regulatory and legislative to ensure that the teaching hospital remains a picture of financial health.

Promises Kept: The University of Mississippi Medical Center

University of Rochester Medical Center - The University of Rochester Medical Center (URMC), located in Rochester, New York, is one of the main campuses of the University of Rochester and comprises the university's primary medical education, research and patient care facilities. URMC includes the University of Rochester School of Medicine and Dentistry, the School of Nursing, the Eastman Dental Center, the University of Rochester Medical Faculty Group, Strong Memorial Hospital and the Golisano Children's Hospital at Strong.

Los Angeles County and University of Southern California Medical Center - The Los Angeles County Hospital and the University of Southern California (USC) Medical School were first affiliated in 1885, five years after the USC was founded. Now known as the Los Angeles County and University of Southern California Medical Center ("LAC+USC Medical Center"), it is one of the largest academic medical centers in the United States and the largest single provider of healthcare in Los Angeles County.

State University of New York Downstate Medical Center - The State University of New York Health Science Center at Brooklyn, better known as SUNY Downstate Medical Center, is an academic medical center and is the only one of its kind in the Borough of Brooklyn in New York City. Older than the Brooklyn Bridge, SUNY Downstate was established as the Long Island College Hospital in 1860 and is the oldest hospital-based medical school in the United States.

University of California, Irvine Medical Center - The University of California, Irvine Medical Center (or UCI Medical Center) is a major research hospital located in the City of Orange. It is the teaching center for the University of California, Irvine School of Medicine.

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