Health Care

At a turbulent time for UM’s health system, a new leader takes the reins

Dr. Edward Abraham, dean of the University of Miami’s Miller School of Medicine, was named full-time CEO of the UM Health System, or UHealth, this week. Abraham takes over UHealth at a time of change in the system’s executive ranks.
Dr. Edward Abraham, dean of the University of Miami’s Miller School of Medicine, was named full-time CEO of the UM Health System, or UHealth, this week. Abraham takes over UHealth at a time of change in the system’s executive ranks. University of Miami Health System

Five months after the University of Miami hired Dr. Edward Abraham as dean of the Miller School of Medicine, UM officials this week named him the full-time chief executive of the UM Health System — the network of hospitals, clinics and doctors that make up the largest and among the most visible UM franchises.

Abraham had been interim CEO of UHealth since Sept. 15, following the resignation of Dr. Steven Altschuler, who quit after less than two years on the job.

In a statement announcing the move, UM President Julio Frenk said Abraham had improved patient access and experience, restructured the medical school’s research strategy, and overseen the recent consolidation of UHealth’s hospitals under a single operating license.

The University of Miami Health System includes Sylvester Comprehensive Cancer Center; Bascom Palmer Eye Institute; UHealth Tower (formerly UM Hospital); more than a dozen outpatient clinics in Miami-Dade, Broward, Palm Beach and Collier counties; and a physician practice of 1,200 doctors.

“I intend to work very closely with him and his leadership team,” Frenk said, “to ensure that we firmly position our institution to face current and future challenges on a strong footing.”

UM officials said they have begun a national search for a new dean to lead the medical school, a job Abraham will continue to do until a successor is named. The announcement said Abraham and UM department chairs have approved a new faculty compensation plan “to ensure that salaries are competitive locally, regionally and nationally.”

Lisa Worley, a UM spokeswoman, did not respond to requests for interviews with Abraham and Frenk. The announcement issued Monday did not include a statement from Abraham, who had been dean of the Wake Forest School of Medicine in North Carolina before joining UM.

He takes over UHealth at a turbulent time for the system.

Following Altschuler’s resignation in September, a raft of UHealth executives also have resigned or been fired by the university, including Dr. Thinh Tran, hired in June 2016 as chief clinical officer and chief operating officer; David Ertel, hired in June 2016 as chief financial officer and chief strategy officer; Roymi Membiela, hired in August 2016 as chief experience officer; Richard Ballard, chief administrative officer and former CEO of Sylvester Cancer Center; and Richard Baum, associate vice president of finance.

Other UHealth executives, including Dr. Michael Barron, named UHealth’s chief medical officer in December 2016, have been demoted, according to UM insiders.

In addition, the university has struggled to turn a profit at the 560-bed UM Hospital, which has been renamed UHealth Tower. The hospital lost $95 million for the year that ended May 31, according to an SEC filing, as operating expenses soar and patient admissions dwindle.

UM Hospital
This November 2011 photo shows UHealth Tower, formerly named University of Miami Hospital, a 560-bed facility in Miami’s Civic Center. The hospital lost nearly $95 million in 2017 as operating expenses spiked and patient admissions dropped, according to a recent SEC filing. CARL JUSTE MIAMI HERALD STAFF

Overall, though, UHealth turned an $83 million profit in 2017 when accounting for all patient care operations — including Sylvester Comprehensive Cancer Center, Bascom Palmer Eye Institute, UHealth Tower, more than a dozen outpatient clinics, and a physician practice of 1,200 doctors.

With $1.6 billion in revenues in 2017, UHealth’s clinical services make up about half of the university’s $2.96 billion in operating revenues.

During the past year, UHealth has been pursuing a strategy to expand its outpatient clinics across Miami-Dade, Broward, Palm Beach and Collier counties in order to deliver medical care to large numbers of people close to where they live.

In November, the university consolidated its hospitals — Bascom Palmer, Sylvester Cancer Center and UHealth Tower — under a single license.

Worley, the UHealth spokeswoman, said the university’s leaders wanted to make the hospital “an all faculty teaching hospital, which was our original goal when we bought it 10 years ago.”

The change meant that more than 100 community doctors who had practiced at the hospital but were not members of UM’s medical school faculty had to reapply for staff privileges.

Worley said those doctors were informed of the change in August and given a chance to apply for voluntary faculty status. “A number of those did become voluntary faculty and they maintained their privileges,” she said. “Those who did not simply did not have privileges any more.”

$1.6 Billion University of Miami Health System patient care revenues in 2017

Dr. Emilio Mantero, a psychiatrist, said he had practiced at the former UM Hospital for nearly 20 years before the university denied his application for voluntary faculty status in October.

“They picked and chose who they wanted,” Mantero said in November. “And they only left a very few. But there was no clear criteria why one was selected and not the other. They left out 100 doctors within a month.”

Mantero said he worried that his patients would have difficulty following him after he lost privileges at the hospital, and that the move did not make sense because community doctors frequently refer patients to UHealth specialists.

Most of all, Mantero said, he felt demeaned by the process.

“They even had the audacity to write us a letter requesting we return the lab coats that we had,” he said. “That’s humiliating. It’s insulting. I’m a University of Miami graduate. ... I trained at the University of Miami. I’m an alumni. My daughters go to the University of Miami.”

Richard Alayon, a Coral Gables attorney, said in November that he had met with a group of doctors who lost privileges at the hospital and were consulting him about their rights.

Alayon said the doctors’ hospital privileges were similar to a contractual agreement, and that because the doctors had followed the hospital’s bylaws they were entitled to an evaluation for retention every two years — and not lose their privileges because the university had consolidated the hospitals under a single license and switched to an all-faculty model.

“You can’t just tell someone who has a contract with you, ‘Sorry, the rules have changed and now I’m going to engage in this sleight of hand,’ ” Alayon said. “They moved a couple of shells around, but it’s still the same hospital. It’s still owned by the same university. It’s still managed by the same board of trustees.”

A previous version of this article reported the wrong amount of total operating revenue for the University of Miami in 2017.

Daniel Chang: 305-376-2012, @dchangmiami

Related stories from Miami Herald