The Reporter: June 1997, Vol.8, No.3
EXTRA! A Special Supplement to the Health Sciences Reporter
Columbia-Cornell Care Takes Off as Physician Recruitment Climbs

More than 1,200 physicians have joined Columbia-Cornell Care L.L.C. (CCC) as the alliance moves from the planning stages into operational mode. The number increases daily as more of the 1,800 targeted members of Columbia and Cornell physician organizations continue to sign up. The latest number, as of June 20, was 1,225.

Message From the Dean Managed care poses a formidable challenge to medical care and particularly to faculty physicians at such academic medical centers as Columbia-Presbyterian and New York-Cornell. To sustain our strength as a clinical enterprise, Columbia and Cornell have come together to create Columbia-Cornell Care. This is a remarkable and innovative development. It brings the doctors together to partner in managed care and related activities while leaving the two schools independent. The best strategy for ensuring reasonable influence at the negotiating table with leadership of managed care is to have a strong and large doctors group. CCC gives us this. Rapidly, it is coming alive: More than 1,200 faculty physicians have signed up; a chief operating officer, Jim Berardo, and a chief medical officer, Jim Lieberman, have been appointed; and CEO candidates are being interviewed. CCC will be able to bring to our physicians more favorable contracts than they would receive as individuals or even small groups. CCC represents a large number of physicians associated with two distinguished academic medical centers. As the regional CCC physician network grows throughout the tri-state area, both employers and insurers will have access to top quality health care throughout the metropolitan region under the CCC banner. This will be attractive to employees as well. Having spent many years as a practicing physician, I know the value of being autonomous and not having to worry about oversight groups or central administration. The reality, however, is that the isolated physician or group of physicians is at risk. Large business interests can ignore them or dictate terms that are very unfavorable. By bringing together this remarkable enterprise, which ultimately will have thousands of doctors and work closely with our two distinguished hospital partners and their affiliated and sponsored hospitals, we will set up one of the most impressive and high quality academic/clinical enterprises in the world. I understand the worries that arise as one has to accept changes in practice routines that have been established for years. However, by bringing together the community of interest--that is, practicing physicians, heads of departments, deans, university leadership--we put together an imposing entity that can advocate and negotiate effectively for all our individual physicians. CCC will become stronger as its membership grows. It will also need the help of many of our faculty physicians to serve on key committees that will have substantial authority and responsibility in attending to the array of issues of finance, contracting, medical management, marketing, etc. I am delighted with the broad support we have received from university leadership, chairs, faculty, and staff. We are launching something that will enable us to maintain high quality medicine and also sustain the fiscal integrity of our collective medical practice in order to support that level of care. I invite you to read the material we have assembled and join us in ensuring a successful future for all of our faculty and our outstanding institutions. Sincerely, Herbert Pardes, M.D.

"There is no more important issue in our survival than bringing P&S and Cornell faculties together to serve as a unified voice for strength in contracting," says Dr. Myron Weisfeldt, acting co-CEO, Columbia-Cornell Care. "The faculties should be congratulated on seeing the clear and unambiguous value in negotiating as a group. We are extremely pleased with the response to CCC thus far."

James Berardo, Columbia-Cornell Care's chief operating officer, reports that CCC is receiving "an extremely favorable response from both physicians and hospitals. As the premier physician organization in the New York metro area, CCC's industry knowledge, leadership, and brand identity provides significant negotiating leverage for our network physicians." Negotiations have resulted in three offers, which are now under consideration.

The leadership of Dr. Weisfeldt of Columbia and Dr. Darracott Vaughn of Cornell, serving in the joint capacities as interim CEO, continues to move CCC forward while a nationwide search for a permanent CEO is conducted. With the assistance of the national search firm of Korn Ferry International, two candidates have made site visits and two more are scheduled soon. All involved are impressed by the high caliber of candidates who have expressed strong interest in the position. They represent an outstanding group of physician leaders who have extensive experience and successful track records in building large, prestigious health care networks and in managed care organization and development. The search committee is co-chaired by Dr. Eric Rose from Columbia and Dr. William Ledger from Cornell.

The partnership between Columbia and Cornell universities formally began Nov. 27, 1996, when officials at both universities signed documents aligning their medical faculties to contract for managed care. CCC is rapidly developing into one of the first physician organizations in the country linking the expertise of two world-class faculties in a clinical collaboration and will be a powerful presence in New York.

"Columbia-Cornell Care is starting to take form as a major player in the marketplace," says Dr. Herbert Pardes, vice president for health sciences and dean of the faculty of medicine at Columbia University. "Other academic centers have not had such foresight, and we will be in a good position to confront the challenges presented by managed care."

Columbia-Cornell Care's priorities and initiatives are being established by CCC's Operating Board, which meets every two weeks.

Four active committees are busy at work on initiatives in managed care contracting, medical management, marketing and outreach, and finance.

Drs. Eric Rose and John Driscoll of Columbia are members of the managed care contracting committee that is developing criteria for contract negotiation.

Columbia's Dr. James Lieberman serves as chief medical officer and chairs the medical management committee, which has inventoried and correlated existing clinical pathways and protocols at each institution. This information is now being used to develop CCC's own clinical pathways and care algorithms for CCC activities at all sites. The committee continues to move forward, Dr. Lieberman says. "We are very pleased with the progress so far, and are now in the process of developing a number of protocols regarding referral management, risk contract quality assurance, risk contract utilization review, disease management, and global packages. We are also developing basic policies and procedures for quality assurance and utilization review."

Columbia-Cornell Care marketing materials aimed at physician practices are under development. A six-color brochure about CCC's management services is in production and the inaugural issue of a biweekly newsletter for faculty practice physicians and administrators was published in June. A CCC web site is also under development. Drs. Richard Levine and Harry Lodge of Columbia are members of the marketing committee. Columbia's Dr. Joe Tenenbaum chairs the finance committee that will develop a budget for the coming year. In addition, CCC will develop satellite offices at each medical center, in lieu of leasing space at a new location midway between Columbia and Cornell.

Columbia and Cornell will invest a total of $45 million over the next five years through CCC to enhance physician practices. These investments are mainly for managed care contracting and medical management expenses, related clinical and business information systems, and two primary care demonstration sites. Columbia and Cornell have committed additional capital for primary care and other investments in the two local physician organizations.