Q and A in Penn Health System: The Hunter Group

Following is another of the e-mail series being used by Dean William Kelley and Interim Chief Operating Officer Robert Martin to update Penn Health System members on the financial turnaround project now in progress.

Who Is The Hunter Group? The Hunter Group is a consulting firm made up of senior health care executives and clinicians. All members have at least 15 years of experience in health care. The team working at UPHS includes individuals with expertise in finance; marketing and managed care; and physician group management. The team also includes a nurse executive, two physicians, and three former health care CEOs.

Does the Hunter Group have experience with academic medical centers? Yes. The Hunter Group's academically affiliated clients have included the University of California-San Diego, George Washington University, Northwestern Medical Center, New England Medical Center, Henry Ford Health System, UCLA Medical Center, and Johns Hopkins Health System. Teams from the Hunter Group are currently at the Detroit Medical Center, the University of California-San Francisco/Stanford Health Care, and the University of Illinois at Chicago Medical Center.

Why do we need to pay someone else to do this work instead of coming up with the ideas ourselves? There are three main reasons for bringing in an outside group:

  • Time: Because they are focused on this one task, the Hunter team can accomplish in 90 days what would take UPHS working alone much longer to do. Given the scope of our challenges, we don't want to waste any time.
  • Objectivity: As outsiders, the Hunter Group team members can be completely objective. They have no obligation to anyone at UPHS except the Steering Committee.
  • Experience: Finally, the Hunter Group has extensive experience helping hospitals and health systems--especially academic medical centers-throughout the country improve their financial situation. They have gathered a wealth of data about the health care industry, including academic health systems and teaching hospitals. Their vast experience has given them a richness of understanding about what has and hasn't worked in other organizations.

How much is the Hunter Group getting paid? The terms of our contract are confidential.

How are they coming up with recommendations? The Hunter Group is reviewing data about all aspects of our operations and interviewing people throughout UPHS. They have already conducted more than 80 interviews. The Hunter Team is also receiving input from the UPHS Management Advisory Work Group, the UPHS Physician Advisory Work Group, and the UPHS Steering Committee.

Will the Hunter Group interview people or observe work on the off shifts? Yes.

How long is the Hunter Group going to be here? Their contract is through the end of November.

Who decides what changes to make? The Hunter Group makes recommendations. UPHS leadership, in consultation with the Steering Committee, will decide which actions to take, and will develop a schedule for putting changes in place.

When will changes start being made? Recommendations are being provided to leadership on an ongoing basis. Final recommendations are expected by the end of November. Implementation may begin as soon as leadership decides.

Where are there opportunities for savings? The Hunter Group is taking a thorough look at the entire Health System. This includes the way we are organized and the effectiveness of our management reporting systems and all of our systems, processes, and infrastructure.

What if employees have ideas? Whom should they tell? Employees can share their ideas with their entity leadership or members of the Steering Committee, Management Work Group, or Physician Advisory Work Group. (Membership lists for these groups were e-mailed to Administrative Forum members on August 12.) You can also give your suggestions to Kathy Tregear, who is serving as staff liaison to the Hunter Group. Kathy's phone number is 215-614-0296. Her e-mail address is ktregear@mail.med.upenn.edu. We also have a 24-hour, toll-free number, 1-877-MY-INPUT (code UPHS), where you can leave questions, suggestions, and concerns.

Why is UPHS losing so much money? Teaching hospitals and academic health systems throughout the country are experiencing severe financial difficulties. Three major causes are contributing to this situation: the Balanced Budget Act of 1997, which slashed Medicare payments; reduced and/or delayed payments from payors (particularly HMOs); and state cuts that have increased the amount of charity care we provide (which at HUP was already the highest in the Commonwealth).

Will employees still receive their incentive payout? Yes.

Is there going to be another layoff? We are awaiting the Hunter Group's assessment and recommendations before we make any large-scale decisions. You can be assured that we are absolutely committed to continuing to provide the highest-quality patient care.

Is UPHS looking at outsourcing support services? We are examining every area of the organization for opportunities to improve our performance, which may include outsourcing certain services.

What is UPHS doing about the Balanced Budget Act? We have been taking our message to Congress and the White House to try to convince them to change the Balanced Budget Act. UPHS is also participating in two major national grassroots efforts to get the attention of our representatives in Washington. Employees can help by sending postcards and e-mails to Congress. (Call 215-349-5136 for more information on the BBA campaigns.)

Why aren't there any nurses or direct patient-care providers on the Steering Committee? Is anybody from direct patient care going to have input to the Hunter Group? Maureen McCausland, chief nurse executive of UPHS, is a member of the Management Work Group. In addition, the Hunter Group is conducting hundreds of interviews with representatives from throughout the Health System. Those interviewed will include nurses and direct patient-care providers.

Almanac, Vol. 46, No. 3, September 14, 1999