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Characteristics of Academic-Affiliated Health Systems.

Matthew J Niedzwiecki1, Rachel M Machta, James D Reschovsky

  • 1M.J. Niedzwiecki is researcher, Mathematica Policy Research, Oakland, California. R.M. Machta is researcher, Mathematica Policy Research, Oakland, California. J.D. Reschovsky is a senior fellow, Mathematica Policy Research, Washington, DC. M.F. Furukawa is senior economist, Agency for Healthcare Research and Quality, Rockville, Maryland. E.C. Rich is a senior fellow, Mathematica Policy Research, Washington, DC.

Academic Medicine : Journal of the Association of American Medical Colleges
|January 9, 2020
PubMed
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Academic medical centers (AMCs) are increasingly joining health systems. Analysis shows distinct academic-affiliated health system (AHS) types, with exclusive medical school relationships becoming less common.

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Area of Science:

  • Healthcare Management
  • Academic Medicine
  • Health Systems Research

Background:

  • Academic medical centers (AMCs) are increasingly integrating into larger health systems due to market pressures.
  • The impact of this integration on the core academic mission (education, research, patient care) remains unclear.

Purpose of the Study:

  • To characterize the types of health systems that owned or managed AMCs in the U.S. in 2016.
  • To understand the evolving relationships between academic medical centers and health systems.

Main Methods:

  • Identified AMCs based on resident-to-bed ratio and medical school affiliation.
  • Utilized the AHRQ 2016 Compendium of U.S. Health Systems to identify academic-affiliated health systems (AHSs).
  • Compared AHSs and non-AHSs on various characteristics including size, services, and medical education affiliations.

Main Results:

  • Nearly all AMCs (95.8%) were part of health systems.
  • 230 out of 626 health systems (36.7%) were identified as AHSs.
  • AHSs were larger, offered more services, and had fewer primary care physicians relative to specialists compared to other systems.
  • Most AHSs had a single, shared medical school relationship (59.1%), while exclusive relationships were less common (16.5%).

Conclusions:

  • Distinct types of relationships exist between academic-affiliated health systems and medical schools.
  • The traditional model of a single medical school holding an exclusive relationship with an AHS is no longer the predominant structure.