U.'s Disease Mgmt. program faces cuts

Despite earning national awards, the program will be hurt by UPHS's woes. It's an award-winning program and a unique initiative that has gained national prominence and attracted the attention of health care providers across the country. But even the 3-year-old Health and Disease Management Program, a crown jewel of the University of Pennsylvania Health System, is unlikely to escape the proverbial chopping block. The program and several others are soon likely to undergo significant workforce reductions as part of a series of sweeping cost-cutting measures intended to remedy the Health System's deepening financial crisis. UPHS is expected to post losses approaching $200 million for the fiscal year that ended June 30. The potential cuts to the program -- a favorite of Health System Chief Executive Officer William Kelley -- underscore the depth of cost-cutting measures the Health System is willing to take. "I think it helps to demonstrate the seriousness of the situation," Health System spokesperson Rebecca Harmon said. The Disease Management Program writes sets of treatment protocols for common diseases in an effort to provide all Penn Health System patients with the same level of care. The protocols are used mainly by primary care physicians to decide which tests to perform for a patient experiencing certain symptoms and when to refer a patient to a specialist. Associate Disease Management Program Director Mark Miani would not say how extensive the cuts to his program would be or when they would occur, but he did say that he was not surprised that his program was among the ones affected. "Even a program as unique as Health and Disease Management is not immune from budgetary realities," Miani said. "We were preparing for this day. It just arrived sooner than we had hoped." Two weeks ago, Kelley sent an e-mail to all Health System employees notifying them of cuts that could affect employees from every corner of the $2 billion Health System. The layoffs come out of initial recommendations made by the Hunter Group, the Florida-based consulting firm that the Health System hired in July to help slash its costs. Officials expect to announce a round of massive layoffs by the end of the month. It is not yet clear which other programs will be affected by the cuts and to what extent, but Kelley has pledged to do whatever is necessary to balance the budget this fiscal year. Despite a potentially smaller workforce, Miani said he is optimistic that the quality of the program will not suffer. Instead, he said the program may become more "efficient" if it succeeds with fewer resources. Specifically, he said the program was developing "revenue-enhancing" programs that would complement the reduced expenses that come with layoffs. "Programs need to be reimbursed or supported more than they've previously been," Miani said. Miani said that the Health System is in talks to partner with other health care providers in use of the program's protocols. While UPHS would generate revenue from these partnerships, outside insurance companies would reap an "economic benefit" from the program's cost-effective standards of care. "It enlarges the program but it diversifies the funding," Miani said. "The goal here is not to get money back to the Health System but it's to be an enhanced program that needs to pay for itself." The Health System signed a contract with a Texas-based health care network about 10 months ago to use the program in hospitals nationwide. The program has written protocols for more than 20 diseases so far. The ones for asthma, diabetes and congestive heart failure are considered among the best. The Disease Management program won three major industry awards last year, including the National Quality Health Care Award, for its combination of patient satisfaction and clinical benefits.

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