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The Task Force on Academic Health Centers, which completed its final year in 2003, addressed the impact of a changing health care financing system on the traditional missions of academic health centers (AHCs): educating future doctors, conducting medical research, pioneering new treatments, providing specialized and cutting-edge services, and caring for indigent patients who have nowhere else to turn. Samuel O. Thier, M.D., president and chief executive of Partners HealthCare System in Boston, chaired the task force; the Honorable Bill Gradison, former congressman from Ohio and current senior public policy counselor at Patton Boggs LLP, served as vice chair. David Blumenthal, M.D., professor of medicine at Harvard Medical School and director of the Institute for Health Policy at Massachusetts General Hospital, was the program director of the task force during its tenure, from 1995 to 2003.
In its final report, Envisioning the Future of Academic Health Centers, (32) the task force presented a blueprint for the future of the nation's teaching hospitals and medical schools. Released in February 2003, the report cautions that future funding of AHCs is at risk. In addition to the pressures caused by spiraling health care costs and rising numbers of uninsured, reductions in Medicare payments to teaching hospitals could seriously affect future funding for AHCs. A recent analysis by the Lewin Group indicates that total mission-related costs, including medical education, in the United States are estimated to be $27.2 billion for all teaching hospitals. After accounting for differences in wages, case mix, and other factors, mission-related activities are approximately 28 percent of total costs ($2,360 per case) for AHC hospitals, compared with 11 percent of total cost ($674 per case) in other teaching hospitals. The task force report contains more than two dozen public policy and private management recommendations intended to strengthen AHCs' leadership role and preserve their key missions. It discusses steps to help AHCs pay for mission-related expenses, rationalize financial management, take advantage of new technologies in education, and demonstrate greater accountability. In addition, the task force proposed creation of a public trust fund to support vital AHC missions and make their financing more accountable, predictable, and transparent.
Drawing heavily on the work of the task force and with support from the Fund, the Institute of Medicine established a committee to study the current role and status of AHCs. The committee's report, Academic Health Centers: Leading Change in the 21st Century, affirms many task force recommendations — calling, for example, for AHCs to take a leading role in transforming the education of health professionals, designing and assessing new structures of care, and adopting advanced information systems on performance, quality, and financial accountability. The Institute of Medicine further recommends that Congress establish an education fund to support innovation in clinical education through a competitive grant process.
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