It Requires Patients : UCI Medical Center should look locally in search for partner

The sweeping changes in health care of recent years have buffeted UCI Medical Center. The Orange teaching hospital has laid off employees, shut community clinics and searched for other hospitals as possible partners to help it stop losing money.

Unfortunately for UCI, the two hospitals it picked late last year as its most likely affiliates have been stung in recent months by allegations of financial wrongdoing. Ten days ago the university wisely ended talks over affiliating with one of the two, Columbia/HCA Healthcare Corp. UCI said it would continue discussions with Tenet Health Care Corp. about a possible link. But it was also wise to indicate that it would continue to cast a wide net for other health care providers that might become partners.

The medical center said it was breaking off talks with Columbia/HCA because the health care chain, the biggest in the country, was focusing so much on being the target of federal investigations and management changes.

Columbia/HCA is facing a sweeping federal probe of suspected Medicare and Medicaid fraud. For its part, Tenet, the nation’s second largest health care chain, several weeks ago agreed to pay about $100 million to former patients who claimed they were illegally held in the company’s psychiatric hospitals in the 1980s and early 1990s. Several years ago, when it was called National Medical Enterprises, the company pleaded guilty to federal conspiracy charges for paying kickbacks and bribes to doctors.

The charges against Tenet and Columbia, both of which operate several hospitals in Orange County, do not mean they provide poor service for patients. Also, while both were talking with UCI, the two companies pledged to continue to operate the medical center as a teaching hospital.

But UCI Medical Center has a special place in Orange County. In a county with no public hospital, it is UCI that has served a disproportionately large number of poor and uninsured patients. That’s a vital role it must continue to play. The charges against Tenet could prove distracting to UCI at a time when it needs to concentrate on its financial problems and on coping with the massive changes in health care.

In the last few years, the medical center’s revenue and number of patients have both dropped. A revamping of the county’s program for Medi-Cal patients has given them the choice of picking doctors, rather than being directed toward the medical center as in the past. Orange County has a number of good hospitals, nonprofit as well as investor-owned, that could be partners with UCI. Looking more closely at those possible affiliations would be a wise move.