Jeffrey P. Gold, MD, president of the University of Nebraska, joined H. Dele Davies, MD, interim chancellor of UNMC, for an all-campus forum on Jan. 6 at the UNMC Omaha campus to address the proposed sole-member governance of Nebraska Medicine.
Current co-member Clarkson Regional Health Services (CRHS) is leaving the partnership and proposing to sell its interest in Nebraska Medicine to the University of Nebraska Board of Regents. A special NU Board of Regents meeting is scheduled for Friday to vote on the board moving toward becoming single owner of Nebraska Medicine.
UNMC’s longstanding primary clinical partner has been wholly governed by the two entities since 1997. That partnership was further cemented by a joint operating agreement signed in 2016.
Dr. Gold explained the announcement came as a surprise to many because he and other stakeholders who have been working on the logistics of the proposal for the past 18 months had been held to strict nondisclosure agreements until it was time for public notice of an NU Board of Regents meeting, which are released one week in advance.
Nearly 800 participated in the forum via Zoom, while in-person attendance approached 100 in the Truhlsen Events Center on UNMC’s Omaha campus.
The proposal by CRHS to opt out and leave the NU Board of Regents as sole member of Nebraska Medicine was presented as “not a multiple-choice question,” Dr. Gold said. CHRS is getting out, he said, and this is its preferred plan. The proposal would include a historic philanthropic investment by CRHS toward completing Project Health
“They have given us a very fixed timeline that this has to occur,” Dr. Gold said. Should the regents not take the opportunity, exclusivity will lapse and open the door for a third party to buy Clarkson’s stake. Potential parties would not be Nebraska entities, Dr. Gold said.
Dr. Davies expressed concern that an outside entity might fill the spot.
How does the state or university have the money to do this in a time of budget cuts?
“The financing of this is completely separately handled from the academic budget,” Dr. Gold said. It would come from a combination of debt service, letters of credit and revenue from real estate currently owned by CRHS, which would be sold and transferred to the university. Financing would be in place and publicly disclosed before the deal closes, Dr. Gold said. CRHS would absorb any shortfall as a result of operating Clarkson College.
The NU Board of Regents becoming sole member of Nebraska Medicine would not make Nebraska Medicine a state entity, nor make its employees state employees, Dr. Gold said.
“None of that is going to change. None of it,” Dr. Gold said.
The university currently has similar agreements with multiple 501(c)(3) organizations under its purview, each of which has its own respective governance.
An attendee expressed concern that as sole member of Nebraska Medicine, the state could have influence over medical and/or research policy. A Nebraska Medicine board would serve much as they do today, Dr. Gold said, such as boards have done so at similar institutions across the country.
Dr. Gold said the university had done its homework on the viability of this model both previously when exploring the 2016 joint operating agreement and especially in the past 18 months, after CRHS proved adamant on taking this action. The Association of American Medical Colleges (AAMC) also has studied governance structure of medical centers and hospital systems extensively. The model where a strong university is sole owner of a health system works well, the president and chancellor said.
“We are not reinventing the wheel here. This is a wheel that has been turning elsewhere that we are trying to emulate,” Dr. Gold said.
“As interim chancellor, I am fully in support of this deal,” Dr. Davies said. He added that it would be best for Nebraska and still enable UNMC to continue to maintain its strong partnership with Nebraska Medicine, noting that in the eyes of most Nebraskans, they were already the same entity.
Dr. Gold acknowledged that there has been some hurt on the Nebraska Medicine side at this development, and that is not the university’s intent.
“The amount of care I have about preserving this relationship and in maintaining a solid future relationship that respects all couldn’t be higher in my priorities,” he said.
“We were as tied together as any organization could be tied. We share the shield that you wear, share a mission statement, share our core values.
“There’s no question there needs to be some healing.”
Dr. Gold said the forum was not the end of the discussion and he welcomes transparent conversations and additional questions before Friday’s regental vote. “The board needs to act to open the door to have these discussions,” he said, which would take place through June 30 and include establishing new bylaws and articles of incorporation.
Medical center faculty, staff and students can view the forum here.