UCI Hospital Chief Foresees Money Woes

Three days into his new job, UCI Medical Center’s executive director said he is confident the hospital has a grip on the fertility scandal that tarnished its name--but financial pressures mean turbulent times are far from over.

Mark R. Laret, former deputy director of UCLA Medical Center, said the UCI hospital already projects a $9-million deficit by the end of this fiscal year next June because of cutbacks in government funding for hospitals that serve a disproportionate share of the poor. The medical center, with net earnings of $11.5 million last year, stands to lose $20 million in those funds this year.

Reductions in Medicare funding also loom, endangering support for medical education at academic institutions such as UCI.

“We have a serious set of problems to deal with before this medical center [can operate] in the black,” Laret said at a press briefing to describe what the hospital’s course will be under his leadership.

The start-up of CalOPTIMA, Orange County’s new managed-care system for Medi-Cal recipients, could drain the medical center still further if patient enrollment in the UCI system can’t be maintained at current levels.

UCI already faces an obstacle there because it did not meet a deadline to be listed as a network in a members’ selection form that CalOPTIMA issued to help patients choose their plans, Laret said. Patients will be able to write in UCI as their selection, however.

Though initially devoting few words to the fertility scandal that has sullied UCI’s reputation nationally, Laret said in response to questioning that he received a “commitment” from top UCI officials that measures will be taken to keep such a controversy from “ever happening again.”

He said he expects an oversight office to be set up soon at the hospital campus to keep an eye on all clinical research at the medical center. That function in the past has been conducted by officials at the main campus in Irvine.

“I will not tolerate anything but the highest moral and ethical standards on this campus,” Laret said.

Three doctors at UCI’s Center for Reproductive Health are accused of misappropriating human eggs and embryos, research misconduct and financial wrongdoing. The center is now closed and the doctors deny they knowingly did anything wrong.

Laret said that UCI faces major “challenges” beyond the scandal and, while the fertility clinic matter should not be minimized, he hopes it is not the dominant issue he faces. “I hope a year from now I will not be discussing that,” he said.

Laret stressed UCI’s assets--particularly its recent designation as a clinical cancer center by federal officials and a 20% increase in federal research funding--outweigh its disadvantages. He also said UCI is being buffeted by many of the same forces that are threatening academic medical centers nationwide.

“Every academic medical center is under tremendous pressure to reduce the costs of care. . . . My game plan at UCI Medical Center is relatively simple. We must find ways to do our work more efficiently,” he said.

To do that, Laret said he will pursue expansion of UCI’s primary care base through affiliations with local and regional physician groups; seek additional contracts with commercial and Medicare health maintenance organizations; and search for ways to collaborate with former rival institutions.

Laret said that he hopes to maintain an “open management style” by consulting frequently with the medical staff and faculty. He replaces Mary Piccione, who was fired after an outside audit faulted her for a style of “management by fear.”