The University of California has five academic medical centers located strategically throughout the state in Davis/Sacramento, Irvine, Los Angeles, San Diego, and San Francisco. UC's academic medical centers include a school of medicine, one or more university teaching hospitals, and, at UCSF and UCLA, one or more other health professions schools. UC's academic medical centers have a three-part mission of teaching, patient care, and research and play a leading role in the development of health services and the advancement of medical science and research.

MEDICAL EDUCATION AND TRAINING PROGRAMS

• The University of California serves as the State's designated research university and is delegated the exclusive responsibility for public university health professions education in medicine, dentistry, and veterinary medicine.

• The University of California operates the largest health science and medical training program in the nation with over 12,000 students annually enrolled in medicine, nursing, public health, pharmacy, and other health professions.

• The instructional program in the health sciences is conducted in fourteen health sciences schools located on six campuses. These include five schools of medicine, two schools of dentistry, two schools of nursing, two schools of public health, and one school, respectively, of optometry, pharmacy, and veterinary medicine.

• UC medical schools educate approximately 2,600 medical students or nearly two-thirds of the state's total each year. Medical student instruction is conducted at UC's five medical center campuses, with four affiliated programs offered at Berkeley, Fresno, Riverside, and the Charles R. Drew University of Medicine and Science in Los Angeles.

• UC medical centers sponsor more than 150 residency training programs representing all recognized specialties and subspecialties of medicine and surgery. More than 4,400 medical residents currently train in these programs with approximately 50% currently enrolled in the primary care specialties of family practice, internal medicine, pediatrics, and obstetrics and gynecology.

• In response to State and national physician needs, UC medical schools have assumed a leadership role in expanding primary care physician training programs. By 2000, approximately 55% of all UC residency positions will be in primary care, with an estimated 20% in family practice.

• UC's medical students, residents, and faculty utilize an extensive clinical resource base which includes nine university hospitals and more than 100 affiliated Veterans Affairs, County, and community-based health facilities throughout California.

• UC medical centers include approximately 3,600 licensed beds in eight licensed acute care hospitals and one licensed psychiatric hospital. These facilities house trauma, burn, and cancer centers, neonatal intensive care units, transplant programs, and a wide range of clinical research and training programs.

• UC operates Level I trauma centers in four of its five regions and provides the physician staff to San Francisco County's General Hospital, including its Level I trauma center.

• UC medical centers provide over 666,000 days of hospital care and more than 2.5 million clinic visits annually. In support of its medical education and patient care programs, UC medical centers collectively employ more than 19,000 individuals.

• UC health facilities constitute a major component of the state's health services "safety net" serving as the major provider to uninsured and underinsured patients in San Diego, Sacramento, and Orange counties.

• UC medical centers rank second only to the Los Angeles County health care system as a provider of Medicaid services in California.

• UC medical centers serve as the largest providers of specialty care for Medicaid beneficiaries in four of their five respective counties.

• In FY 1995-96, 56% of UC hospital patient days were paid through federal Medicaid (31%) and Medicare (25%) programs. Whereas 36% of patient days were covered by private payers, including managed care (32%) and fee-for-service (4%) plans. The remaining patient days (8%) were county- reimbursed, State-supported or uninsured/self-pay.

• State funding contributed about 2% of UC hospitals' FY 95-96 total budget of about $2 billion. Patient care revenues make up almost all of the remainder with a small portion (2%) derived from non-clinical revenues.

• Among total net patient revenues in FY 1995-96, 49% came from private payers including managed care (41%) and fee-for-service (8%) plans. Federal program revenues represented 43%, with Medicare at 29% and Medicaid at 14%. The balance (8%) was provided through public, both State and county, programs and by uninsured and self-pay patients.

• In FY 1995-96, UC medical centers were reimbursed about $209 million less than the costs of services for Medicaid beneficiaries. Including Medicaid losses, UC provided about $378 million in uncompensated care to low-income patients.

• Through its Disproportionate Share Hospital payments (DSH), Medicare reimbursed UC $52.6 million for the care provided by UC hospitals serving (in the past fiscal year) as disproportionate share providers to medically indigent patients, including those patients covered by Medicaid.

• In FY 1995-96, Medicare's Indirect Medical Education (IME) adjustment provided UC $107.3 million as compensation related to the severity of patient illnesses, scope of services provided, and other costs related to medical student and resident education (excluding resident salaries).

• In FY 1995-96, Medicare's Direct Medical Education (DME) payments to UC totaled $24.1 million to cover a portion of the costs associated with resident salaries and faculty teaching and supervision. Only Medicare (IME and DME) pays for costs related to medical education.

• Medicare's medical education and medically indigent payments are 9.6% of UC's total net revenues.

• The UC medical centers are located in five of the most competitive markets in the nation (i.e., Sacramento, Orange, Los Angeles, San Diego, and San Francisco counties). For example, in contrast to the 23% nationwide average, more than 36% of Californians are currently enrolled in HMOs.'

• Among California's Medicare recipients, 28% are enrolled in HMOs compared with the 8% national average. In San Diego and Los Angeles Counties, the proportion of Medicare HMO-enrollees significantly exceeds state and national averages, at 35% and 40% respectively.

• More than 50% of California's Medicaid recipients are expected to be covered by HMOs by 1997 (versus 15% nationally). Growth is projected to occur rapidly in all UC medical center regions.

• Negotiated prices with managed care payers has limited cost-shifting by California teaching hospitals. This strategy has been used by UC hospitals to cover costs related to uncompensated and undercompensated patient services.

• UC health sciences programs bring together the critical mass of distinguished faculty and bright students to create innovations in basic research which lead to changes in patient care for both acute illnesses and for prevention. They also train the skilled workforce necessary to bring these changes to the marketplace and the bedside.

• UCSF, the epitome of a complex academic health center, ranked #1 in 1993-94 research funds awarded by the National Institutes of Health. The School of Pharmacy ranked first among 57 schools ($13 million); the School of Medicine ranked second among 128 schools ($169.9 million); the School of Dentistry ranked first among 52 schools ($9.9 million); and the School of Nursing ranked second among 79 schools ($4 million).

• 50 out of the 80 companies located around UCSD which can trace their roots to directly to campus- based research (much of it in the biomedical sciences), offer employment to more than 7,000 people at an annual payroll of $300 million. Companies with ties to UCSD supply 23 percent of the jobs in local biotechnology and biomedical industries.

• Scientists at two of California's most prestigious academic medical centers, Stanford and UCSF, created the technique of gene-splicing, which created the entirely new biotechnology industry. One of these scientists, Herbert Boyer of UCSF, subsequently co-founded Genentech, Inc.
  • 1 in 3 US biotech firms is located within 35 miles of a UC campus
    
  • 1 in 6 California firms was started by UC scientists
    
  • 6 of the 10 top-selling biotech drugs stem from UC research
    

• UC biomedical research faculty based at the various academic medical centers, have developed other major medical advances through their pioneering research. Such research has resulted in many lives saved, disabilities avoided or reduced, more cost-effective treatments and the creation of other new industries. Such advances include:
  • the nicotine patch
    
  • cochlear implants
    
  • artificial lung surfactants for treating premature newborns
    
  • Magnetic Resonance Imaging
    
  • catheter treatment for brain aneurysms
    

UC Academic Medical Center Service Statistics by Payer FY 95-96

Patient Days: 31% Medicaid 25% Medicare 32% Managed Care 4% Fee-for-Service 8% Other

Net Revenues: 14% Medicaid 29% Medicare 41% Managed Care 8% Fee-for-Service 8% Other