Mission-based budgeting for education: ready for prime time?

Mission-based budgeting has been touted as the preferred method of assessing and assigning departmental budgets in academic medical centers. Mission-based budgeting in its simplest form is a methodology that allows an institution's finance department to align costs with actual activities (typically clinical care, administration, research, and teaching). Despite its intuitive appeal, a minority of the academic medical centers across the country have embraced it. Mount Sinai School of Medicine was among the first to incorporate this approach, and we have almost a decade of experience with its risks and benefits. This article focuses on the education component of mission-based budgeting. We review all aspects of mission-based budgeting, including (1) the many variables that must be factored into a metric and how those variables differ among institutions, (2) the metric itself and how it reflects institutional philosophy, (3) the impact of mission-based budgeting on faculty and chairs of departments, (4) existing processes that ensure the quality, reliability, and validity of the different mission-based budgeting systems, and (5) a comparative perspective.