A new customer
If it works, those paying customers will bring their insurance cards, providing UNM with more and more reliable revenue. Those specialized services will attract federal money and foundation grants. Pharmaceutical companies will fund research and clinical trials. Drugs developed at the UNM Cancer Center, for example, will be licensed to the drug industry. Better facilities and a focus on research will attract better faculty. More money in the system means more resources for indigent care. More services mean better health for everyone, insured or not.
That, at least, is the plan. First, the new Cancer Center and other services UNM will offer have to be built.
The Cancer Center, scheduled to open in early 2009, will house ambulatory cancer treatment, research facilities, state-of-the-art treatment and diagnostic technologies and capacity to develop novel radioisotopes for imaging and treatment. Sixty cancer physicians, 110 research scientists and 400 nurses and other staff will work there.
By the numbers
The four-floor center will be able to handle 200,000 patient visits a year. It will have 40 examination rooms, 30 infusion rooms, four linear accelerators for radioisotope production, three surgical suites, pharmacies and a clinical laboratory.
The UNM Cancer Center is already one of 60 designated by the National Cancer Institute as a pre-eminent cancer center. Its CEO, Cheryl L. Willman, wants it to become one of the top 20 cancer centers in the country.
"In many ways, we're a test case for the Health Sciences Center," Willman said. She began by doing her own world-class research, then began looking for some of the nation's best physicians and researchers. She focused on finding the No. 2 man or woman in a major research program who was ready to step up to No. 1.
Willman recruited 47 doctors in the past four years. "We have fantastic physicians in the Cancer Center who could hold their own with anyone," she said. "They came here because they wanted to build a program."
Improved quality of care enabled UNM Cancer Center to gain a 40 percent market share among adult cancer patients and almost 100 percent of children with cancer.
The next step
The next step is the new building, which, like the new UNM Hospital pavilion, is designed to offer patients and physicians a comfortable, attractive and technologically advanced environment. Attractive facilities help recruit new doctors and improve patient and employee satisfaction, the plan says.
Willman is developing partnerships with the national laboratories, drug companies and local biotechnology firms. UNM is building a statewide network of cancer care expertise with the UNM Cancer Center as the home to specialized care and expensive technology.
Center researchers want to understand health disparities, Willman said. Research shows cancer afflicts different racial and ethnic groups differently, she said. For example, Anglo women with breast cancer seem to benefit more from chemotherapy than Hispanic or Indian women. Willman thinks drugs tailored to different racial and ethnic groups might be necessary.
The Health Sciences Center plan calls the cancer service one of its signature clinical programs. It anticipates signature programs to provide services for children and mothers, neurology, trauma and critical care. They were chosen, Roth said, because UNM faculty have expertise and the university could build the infrastructure to support them.
Pressure
Financial pressure is behind UNM's new direction, Roth said. Government provides about 10 percent of the Health Sciences Center's approximately $1 billion operating budget. The rest comes from insurance, grants, tuition and other sources.
"For the most part, the only way we've been able to cover the costs of increasing access for the uninsured and under-insured is by cost-shifting— transferring what ever we happen to be making on one side of the house over to subsidize the cost of providing safety net service," Roth said.
About three years ago it became obvious the gap between the cost of providing uncompensated care and UNM's ability to cover the costs by shifting resources was big and widening, Roth said. "We began compromising almost beyond the point of recovery certain parts of the institution, which impacted the program," he said.
UNM began lobbying for more public funding for the under- and uninsured, and it started "growing our programs so individuals with some form of reimbursement would want to come," Roth said.
A rising tide
The result should help everyone, what ever their personal finances might be, Roth said. More resources will let UNM HSC look for solutions to uniquely New Mexico problems, like high rates of trauma, alcohol-related injuries, teen suicide and teen pregnancy, diabetes and unique cancers. "Those issues impact everybody's lives," he said.
"Our view and my personal view is that New Mexico deserves better than average," Roth said. "I'm not sure if the public broadly within New Mexico should be content with a mediocre medical school that just sort of does a mediocre job in science."
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