Campus Medical Center Fact Sheets:
-Davis
-Irvine
-Los Angeles
-San Diego
-San Francisco

MEDICAL EDUCATION AND TRAINING PROGRAMS

• The UCSD School of Medicine admitted its charter class in Fall 1968. Current medical student enrollment averages approximately 500 students per year.

• UCSD continues to rank among the top tier of US medical schools in both the proportion of its graduates pursuing primary care careers and in the total volume of federal research funding.

• At the graduate level, UCSD currently trains more than 500 medical residents, with approximately 40% in the primary care specialties of family practice, internal medicine, pediatrics, and obstetrics and gynecology.

• Clinical teaching sites used in connection with campus-based and affiliated programs include the UCSD Medical Center (UCSDMC), San Diego VA Medical Center (SDVAMC), Children's Hospital and Health Center, Mercy Hospital, Navy Regional Medical Center, and over 20 other affiliated hospitals, clinics, and long-term care facilities.

• UCSD's clinical enterprise encompasses a full array of health services, including two acute care hospitals and the UCSD Healthcare Network, a system of affiliated community hospitals, community clinics, and physician group practices throughout San Diego County. The UC medical staff consists of almost 1,000 primary care and specialty physicians, many of whom have gained national reputations for excellence.

• UCSD's two hospitals provided 102,497 days of hospital care and 548,697 clinic and emergency visits in FY 1995-96.

• In FY 1995-96, 52% of UCSD's hospital patient days were paid by the federal Medicare (18%) and Medicaid (34%) programs. 31% of patient days were covered by private payers, including managed care (29%) and fee-for-service (2%) plans. A significant percentage of patient days (17%) were covered by the public programs, primarily the County's indigent care program, or were uninsured/ self- pay.

• The Medical Center is also the largest provider of specialty/ tertiary care to Medicaid beneficiaries in the county.

• UCSD has the most significant proportion of patients who are underinsured or uninsured, with half of medical center inpatients falling into this category. This is largely the result of contracts with the County to provide emergency room and other clinical care to medically indigent patients, and its past history as the County hospital.

• The School of Medicine operates an acute psychiatric hospital for children and adolescents under contract with the County.

• Among total net patient revenues in FY 1995-96, 46% came from private payers, including managed care (40%) and fee-for-service (6%) plans. Federal program revenue represented 45%, with Medicare at 24% and Medicaid at 21%. The remaining revenue (9%) was from the County contract, State support and uninsured/self-pay patients.

• In FY 1995-96, UCSD's reimbursement for patient care services to Medicaid beneficiaries, including disproportionate payments, was $21 million less than the cost of providing these services. Including losses from Medicaid, the total estimated cost in excess of reimbursement for low-income patients was $49 million.

• In FY 1995-96, Medicare's Disproportionate Share Hospital (DSH) program reimbursed UCSD $6.5 million for care provided to its disproportionate share of medically indigent patients, including those covered by Medicaid.

• In FY 1995-96, Medicare's Indirect Medical Education (IME) adjustment provided UCSD $9 million as compensation for the severity of patient illnesses, scope of services provided, and other indirect costs incurred related to medical student and resident education.

• In FY 1995-96, Medicare's Direct Medical Education (DME) payments to UCSD were $2.6 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 indigent payments made up 6.5% of UCSD's total net revenues.

• In response to perhaps the most competitive regional market in California, UCSD has formed an integrated delivery system, one of four major systems in the area competing for managed care patients.

• UCSD is extremely vulnerable to State and federally imposed reductions in disproportionate share funds for Medicare ($6 million) and even more so for Medicaid ($15 million).

• Rapid growth in managed care for Medicare and Medicaid in the San Diego market presents the prospect for UCSD to lose traditional patients to competitors while facing lower payments for those patients who are retained.

• Due to its proximity to the U.S.-Mexico border, UCSD provides emergency services to a significant number of illegal immigrants. A majority of these patients are admitted in compliance with federal law mandating emergency services. Almost all of the undocumented emergency and trauma patients were unfunded or underfunded. UCSD Medical Center provided approximately $12 million in unreimbursed care to these immigrants in FY 1995-96.

UC San Diego Medical Center Service Statistics by Payer FY 95-96

Patient Days: 34% Medicaid 18% Medicare 29% Managed Care 2% Fee-for-Service 17% Other

Net Revenues: 21% Medicaid 24% Medicare 40% Managed Care 6% Fee-for-Service 9% Other