Campus Medical Center Fact Sheets:
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-San Francisco

MEDICAL EDUCATION AND TRAINING PROGRAMS

• The UC San Francisco (UCSF) School of Medicine was established as a private medical college in 1864 and became part of the University of California system in 1873. Since then, UCSF has earned a distinguished reputation as a world-class medical school and leader in biomedical research.

• The UCSF Medical Center is part of a unique health sciences campus which has nationally-ranked Schools of Medicine, Dentistry, Nursing and Pharmacy and a broad array of biomedical training and research programs which have earned national and international reputations. All four UCSF schools ranked first or second in the nation in 1994 in total research dollars received from the National Institute of Health.

• A December 1994 study by the Association of American Medical Colleges (AAMC) reported that in FY 1992-93, UCSF ranked second (and first among public universities) in total awards of federal research contracts and grants with $158.3 million. The same study also ranked UCSF as among the top medical schools nationwide in the percentage of its 1988, 1989, and 1990 graduates entering primary care specialties.

• UCSF currently trains approximately 650 medical students and nearly 1,200 medical residents per year.

• The recently approved merger of the UCSF and Stanford Medical Centers (effective July 1, 1997) is expected to sustain the clinical base needed to compete in a managed care environment. The Schools of Medicine of UCSF and Stanford will continue to operate as separate and distinct entities, with each benefitting by improved access to a broadened patient base.

• UCSF's clinical enterprise includes two acute care hospitals and a psychiatric hospital (961 licensed beds), multiple ambulatory clinics, and a clinical faculty group of 950 primary care and specialty physicians, many of whom are nationally and internationally regarded. This data is consolidated for all three hospitals at UCSF.

• UCSF's three hospitals provided 160,215 days of hospital care, 439,145 clinic and emergency visits, and over 56,000 home health visits in FY 1995-96.

• In FY 1995-96, 57% of UCSF's hospital patient days were paid by the federal Medicare (31%) and Medicaid (26%) programs. 40% of patient days were covered by private payers, including managed care (35%) and fee-for-service (5%) plans. The remaining days (3%) were for publicly supported and self-pay patients.

• Ranked nationally in most of its specialty/tertiary areas, UCSF attracts one-third of its patients by referrals from outside of the five-county Bay Area.

• UCSF provides more than one-third of all Medicaid services in San Francisco and is the thirteenth largest Medicaid provider in the state. UCSF is also the largest provider of specialty/tertiary care to Medi-Cal beneficiaries in the five-county Bay Area.

• The School of Medicine provides the physician staff by contract for San Francisco County General Hospital, which includes its specialty clinics and nationally regarded AIDS program and trauma center.

• UCSF is a self-sustaining enterprise which received 3.2% of its revenue through a State appropriation.

• Among total net patient revenues in FY 1995-96, 46% came from private payers, including managed care (35%) and fee-for-service (11%) plans. Federal program revenue represented 48%, with Medicare at 38% and Medicaid at 10%. The remaining revenues (6%) were from public support, primarily State, and self-pay patients.

• In FY 1995-96, UCSF was reimbursed $58 million less than the costs of services provided to Medicaid beneficiaries.

• In FY 1995-96, Medicare's Disproportionate Share Hospital (DSH) program reimbursed UCSF $14.2 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 UCSF $32.8 million as compensation for the severity of patient illnesses, scope of services provided, and other indirect costs incurred in related to medical student and resident education.

• In FY 1995-96, Medicare's Direct Medical Education (DME) payments to UCSF were $8.8 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 11.4% of UCSF's total net revenues.

• The San Francisco Bay Area is one of the most competitive markets in the country. Recent data indicates that 67% of San Francisco employees are enrolled in HMOs and 88% are enrolled in some form of managed care. Due to intense cost-based negotiations with managed care payers, UCSF's ability to shift costs for medical education and indigent care to private payers has been greatly restricted.

• Decreasing inpatient utilization has created severe overbedding in the regional market. Hospital occupancy rates average less than 50% in the region.

• Although long recognized as one of the lowest-cost academic medical centers in the country, UCSF must reduce its workforce substantially to remain financially solvent. Such reductions assume current Medicare and Medicaid reimbursement levels. UCSF has reduced expenses $56 million over the last three fiscal years.

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

Patient Days: 26% Medicaid 31% Medicare 35% Managed Care 5% Fee-for-Service 3% Other

Net Revenues: 10% Medicaid 38% Medicare 35% Managed Care 11% Fee-for-Service 6% Other