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Minutes: June 21, 2006

3 p.m., Wednesday, June 21, 2006
School of Medicine Administration, Board Room 103

PRESENT: Drs. Caterina, Choi, Dagnelie, Hillis, Holcroft, Honeycutt, Lehmann, Sterni, Yaster, Zellars, Mr. Watkins, Mss. Foy and Sandone.

ABSENT: Drs. Adger, Ain, Aucott, Bergles, Bhatti, Blok, Chan, Colecraft, Cooper, Cormack, DeLeon, Denmeade, Efron, Flynn (excused), Gabrielson, Guity, Huang, Iacobuzio-Donahue, Liu, Lorsch, Magaziner, Martins, Miller,  Mooney, Niv, Peters, Pidcock (excused), Pomper, Robinson, Roper, Schulick, Tompkins, Walker, Woolf, Messrs. Bagga Grelotti, and Prucz. Ms. Cohen,

GUESTS:   Dr. Baumgartner, Mr. Wilczek, Mss. Haldeman, Hayes and Heiser.

I.  Minutes

The minutes of the May 24, 2006 meeting were approved.

II. Clinical Practice Association (CPA) Update – Dr. William Baumgartner, Vice President for Clinical Affairs, and President of Clinical Practice Association and Mr. Ken Wilczek, Assistant Dean for Clinical Practice

Dr. Baumgartner provided background on the structure of the CPA.  The CPA was restructured in 1997 and the senior management team is still intact.  Six elected clinical chairs and three at-large members are elected by the clinical faculty.   All department directors are invited to attend meetings.  Senior administrative offices of Johns Hopkins Medicine and a basic sciences director are also attendees and sit on the Board of Governors.  A hand-out describing the governance and the membership of key administrative committees was circulated.  Dr. Baumgartner reported the merger with Johns Hopkins Bayview is on track and the Bayview component is profitable.

Mr. Wilczek addressed several financial concerns relating to reimbursement.  Medicare reimbursement continues to be a challenge.  Currently 25% of clinical volume is Medicare; by 2020 it is projected this may reach 40%.  Current payment levels do not meet the costs of providing care.  Projected reimbursement rates using the current Sustainable Growth Rate Formula, which is viewed by the CPA as flawed, will further decrease reimbursement.  No short term fix is in sight as the costs run into the billions of dollars.

Mr. Wilczek addressed the Medicare Modernization Act which encourages insurance companies to offer managed care Medicare plans.  He spoke to the pros and cons of mergers with major carriers.  He also addressed the “pay for performance” approach which introduces quality into the payment equation and a pilot project “Medicare Quality Demonstration Program” in which the CPA may participate.

Mr. Wilczek, in responding to questions, indicated all activities are faculty driven; the CPA Board and administration facilitate the process.  He indicated national organizations can and do play a role in working with legislative leaders in solving funding issues.  Mr. Wilczek also commented on the complex issue of third party clinical trial coverage and noted a consulting group has been working with the school to develop compliant systems.

Faculty opt-out as a BlueCross/BlueShield provider was also addressed.  Mr. Wilczek explained the allowable reasons and noted that a very small number of faculty are in this category.  He encouraged the faculty to read Change in order to keep abreast of CPA activities and financial reporting.  Dr. Hillis thanked Dr. Baumgartner and Mr. Wilczek for their presentation.

III. Marketing at Peer Institutions: Discussion of Future Inititatives at Johns Hopkins – Ms. Dalal Haldeman, Vice President for Marketing and Communications

Ms. Haldeman, the newly appointed Vice President for Marketing and Communication, presented an overview of a marketing program at a peer institution.  She addressed various marketing initiatives effectively used by the Cleveland Clinic to recruit local, national, and international patients.  Although recognizing this model might not be appropriate for all academic institutions, she thought it helpful for the Medical School Council to hear about another institution’s successful approach.

Dr Hillis inquired about plans for improving the Johns Hopkins Medicine web-site, especially key-word optimization, making it easier for patients seeking information and care.  Ms. Haldeman indicated this was a priority and a consultant has been employed to assist in the project.  In addition to web-site improvement, Ms. Haldeman noted “brand protection strategy” as another major priority for the marketing and communication staff.

Dr. Hillis thanked Ms. Haledman for her presentation and indicated willingness on the part of the Medical School Council in redesigning the web-site.

IV. Update on Flexible Spending Accounts – Ms. Charlene Hayes, Vice President for Human Resources

Ms. Hayes was invited to report on the Dependant Care Flexible Spending Accounts and the implication to faculty if the University did not meet the annual IRS non-discrimination test. 

As background, during the 2005 calendar year the University’s non-discrimination test took place late in the year.  The University failed the test which adversely affected a significant number of faculty who were using the flexible spending account.  Ms. Heidi Conway, Senior Director for Benefits Planning and Administration, addressed the council on this issue in January 2005 reporting that the average benefit for non-highly compensated employees did not equal 55% of the average benefit for highly paid employees (those making in excess of $95,000 annually), thereby reducing by 39.8% the amount highly compensated employees could contribute to this tax favored benefit.  At that time a number of suggestions were put forth to the benefits office regarding strategy to increase participation of lower paid employees in the plan.

The 2006 non-discrimination test is now being conducted by WageWorks, the new vendor for the flexible spending accounts.  Ms. Hayes was not optimistic the university would pass the 2006 test, thereby creating a similar situation this year, albeit earlier.  Higher paid faculty using the benefit will not be able to take full advantage of the tax benefit if the University does not pass the non-discrimination test. 

The Medical School Council again made recommendations to Human Resources to be proactive in encouraging lower paid employees to participate in the plan.

Dr. Hillis thanked Ms. Hayes for her presentation.

V. Other Business

There being no further business this meeting was be adjourned at 5:00 p.m.

Respectfully submitted,

Mary E. Foy

Future Medical School Council meetings:

All meetings will be held in the School of Medicine Board Room (SOM 103), 3:00 to 5:00 p.m.September 20, 2006
October 18, 2006
November 8, 2006
December 13, 2006
January 17, 2007
February 14, 2007
March 21, 2007
April 18, 2007
May 23, 2007
June 20, 2007