Survey of overhead assessments of academic health center radiology departments

Abstract

M ost academic health centers impose assessments, or taxes, on faculty-generated patient care reve nues. Assessments require departments to contribute some portion of patient care earnings to meet broader health center goals. These assessments are used to fund certain overhead and research costs, such as the dean's office, building programs, practice plan administration, billing services, and research that does not command external funding. Although the level of assessments can be somewhat misleading because deans can withhold hard funds in lieu of assessments, it is still important that assessment mechanisms be understood and considered fair and equitable by all interested parties [1]. Cur rently, tensions are common between deans and department chairpeople regarding the allocation of practice plan revenues [2]. At meetings of the Society of Chairmen of Academic Radiology Departments (SCARD), concerns have been expressed regarding the diverg~ence in department assessments among academic health centers. Consequently, the SCARD supported a survey to increase understanding of the types and levels of assessments placed on academic departments of radiology. Prelimi nary findings were presented at two meetings of the SCARD, and recommendat ions received were incorporated into the study. Although the survey did not consider the overall distribution of funds in surveyed centers, it did profile existing characteristics of assessments and measure central tendencies. These data may foster improved comprehension and development of equitable assessment systems. The integrity of assessment systems is particularly important because it is unclear whether practice plans can continue to support academic health centers at established levels if practice revenues are constrained by federal or state health reform efforts [3] and if reform entails using patient care dollars to build and sustain community-based delivery systems [4]. In addition, greater reliance of academic health centers on patient care revenues can further exacerbate the existing dilemma of faculty in spending increased time generating patient care revenues at the expense of teaching and research [5].