UAMS, Baptist set goals as team

The University of Arkansas for Medical Sciences, Little Rock has partnered with Baptist Health in an effort to expand residency programs and to improve health in the state.

The two announced their plans to work together in a statement of strategic intent Tuesday. In part, the collaboration will include the creation of a Medicare shared-savings organization — Baptist Health/UAMS Accountable Care Alliance — that will identify 50,000 Arkansans who are Medicare patients and allow the two systems to measure health care delivery quality and costs to the patient, said Troy Wells, Baptist Health’s CEO.

“In recent years, we have built trust and respect between our organizations by working together to improve care delivery across a number of clinical services,” the statement said. “Our work together has confirmed our ability to strengthen the quality, breadth and cost efficiency of our clinical programs for the benefit of those we serve. These early successes motivate us to explore where we might take our collaboration to a new level to deliver to our constituents a broader range of benefits across our patient care, educational and community service missions.”

UAMS had started down a similar road in 2013 with CHI St. Vincent. But the Denver-based Catholic Health Initiatives was interested in forming a combined clinical enterprise with UAMS, said Leslie Taylor, UAMS’ vice chancellor for communications and marketing, and the state’s academic medical center couldn’t agree to that.

Tuesday’s agreement states that UAMS and Baptist Health will remain separate institutions but will work “to offer a wider range of educational opportunities and to deliver clinical care more efficiently and effectively than either institution can do on its own.”

As part of the educational opportunities, the two plan to add 117 new residency slots over time, said Stephanie Gardner, UAMS’ interim chancellor.

Medical school students need postgraduate education, typically a residency, before earning a license to practice.

Nationwide, the schools have increased enrollment by nearly a quarter since 2002 as a response to an impending physician shortage. A study commissioned by the Association of American Medical Colleges estimated that by 2030 there would be a primary-care physician shortage of between 7,300 and 43,100, and in specialty areas of between 33,500 and 61,800.

Residency slots haven’t kept pace with the increase in medical graduate students. The problem is also exacerbated by the bottleneck from a federal cap placed on fiscal support of the programs.

Residents’ salaries are paid by the hospital, which can later be reimbursed through federally funded Medicare. Congress placed a cap on the federal fiscal support more than 20 years ago, limiting the number of residency positions across the nation, according to the medical college association. The cap does not apply to hospitals that have never previously participated in residency training.

That’s why others, including the New York Institute of Technology’s College of Osteopathic Medicine’s campus at Arkansas State University, have helped raise the number of residency slots in a state with historically poor health outcomes.