The Miami Herald: FIU’s role increasing, UM’s changing at Jackson Health System

By John Dorschner

Jackson Health System leadership agreed Friday to what a board member called an “historic” agreement with Florida International University while paving the road for a completely new relationship with the University of Miami.A committee of Jackson’s governing board approved a plan to bring doctors from FIU into Jackson Memorial Hospital for the first time, a major step in an arrangement that will expand in the coming years. The board also approved a change in the UM contract and received a memorandum of understanding that will mean a radical departure for Jackson’s 60-year relationship with UM’s medical school.

“This is an historic milestone for Jackson, an historic milestone for FIU,” said board chairman Marcos Lapciuc. “Ultimately, the community benefits.”

Chief Strategy Officer Donn Szaro told the committee that the memorandum laid out a “whole new arrangement” with UM, beginning June 1, in which the public hospital will “lease” some UM doctors, paying directly for their services, a move intended to end ongoing accusations that UM doctors sometimes choose to admit paying patients to UM’s own hospital while treating the uninsured at Jackson Memorial.

UM Dean Pascal Goldschmidt called the new plan “the simplest and best model. There’s no confusion there at all. What you see is what you get. We should have been in that model from the get-go,” rather than the present model in which Jackson pays a lump sum of over $100 million for UM services.

The changes are likely to mean fewer UM doctors at Jackson, with more physicians coming from FIU and the community.

Faculty members from FIU’s medical school, which accepted its first students in 2009, have been working at Jackson North, but until now the public hospitals’ flagship facility, Jackson Memorial, has been the domain of UM, which currently supplies 97 percent of the doctors there.

The new arrangement will start with Jackson paying for 4.5 FIU doctors who will serve as Jackson Memorial hospitalists, handling in-patient treatment for 13 beds and ramping up over time. Jackson will pay about $1 million toward the doctors’ salaries while receiving all the income the doctors generate from insurance companies.

“This is only the first stop of FIU’s integration into Jackson Memorial,” said Chief Executive Carlos Migoya.

Szaro pointed out that FIU has adjunct faculty of 1,000 or more community doctors who assist the medical school. Opening a path for them at Jackson Memorial could reduce the reliance on UM doctors. Migoya has said that he hopes eventually to have a third to half of Jackson’s doctors be from the community, rather than from UM.

FIU doctors also have relationships with the area’s Federally Qualified Health Centers, community clinics treating many Medicaid patients. Having FIU hospitalists at Jackson will serve as a link to attract FQHC patients. This could pave the way for a system of integrated care, which the Affordable Care Act promoted as a way of providing cheaper, safer treatment by using firm connections between primary care and hospitalists.