Securing a Network for a Research-Intensive, Referral Academic Medical Center: University of Kentucky HealthCare as a Case Study

Robert L. Edwards, Mark D. Birdwhistell, James W. Zembrodt, Mark F. Newman, Michael Karpf

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Over the last 15 years, UK HealthCare, the clinical enterprise of the University of Kentucky, has undertaken 3 clinical strategic plans to secure its position as a research-intensive, referral academic medical center. The first plan, titled Securing the Traditional Marketplace (2005-2010), focused on building advanced subspecialty programs on campus while pursuing partnerships with providers in UK HealthCare's traditional marketplace, eastern Kentucky. The second plan, Expanding the Footprint (2010-2015), recognized that UK HealthCare needed to cover a population base of 5 to 10 million people to support its subspecialty programs. These 2 strategic plans were successful and achieved 4 outcomes: a doubling of annual discharges, a dramatic increase of transfers/external referrals, a significant increase in the case mix index, and impressive growth in subspecialty programs. The third clinical strategic plan, Preparing for Change (2015-2020), has expanded UK HealthCare's gains in the face of rapidly changing reimbursement systems and delivery models. The pillars of this plan are responding to consumerism, strengthening hallmark programs through service lines, "hard wiring" relationships with partnering organizations including establishing the Kentucky Health Collaborative, and building infrastructure to deal with risk-based reimbursement. UK HealthCare is trying to spearhead a rational system of care for Kentucky rather than a system that rations care. Halfway through the third clinical strategic plan, UK HealthCare has seen increased discharges, transfers, and clinical expansion in its hallmark programs, building evidence that well-thought business practices can lead to improved public policy.

Original languageEnglish
Pages (from-to)1895-1902
Number of pages8
JournalAcademic Medicine
Issue number12
StatePublished - Dec 1 2019

Bibliographical note

Funding Information:
Plus plans is a direct manifestation of its effort to move patients into systems that accept risk.11,12 The ultimate end point of risk-based reimbursement is capitation and fixed budgets. Block grants and per capita grant funding of Medicaid—part of the current debate— are attempts to move to fixed budgets for Medicaid. Consequently, the strategic plan developed at UK HealthCare included efforts to prepare for risk-based reimbursement and recognize that the organization might ultimately have to prepare for the possibility of fixed budgets or capitated systems.13

Publisher Copyright:
Copyright © 2019 by the Association of American Medical Colleges.

ASJC Scopus subject areas

  • Education


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