July 2, 1998

At our June 30 communications meeting, Susan Carullo of the Medical Center Human Resources office updated the management team on the work of a committee involved in improving our performance appraisal system. Details of her presentation are outlined below. In general, the committee hopes to streamline the performance appraisal, or EPMS, and position description documents by combining them into a single document. Among other things, the proposed new document will include some preprinted statements for evaluation of core competencies and values which we have embraced as an organization.

While this work to improve our future performance evaluation instrument and system is under way, supervisors throughout the Medical Center must continuously be accountable for evaluating employees fairly and in a timely manner. Everyone deserves to have timely feedback on performance. I ask that all supervisors give this matter their attention.

W. Stuart Smith, Interim Vice President for Clinical Operations Interim CEO, MUSC Medical Center

Announcements

• Susan Carullo, manager of Employment, Compensation and Employee Relations, for the Medical Center Human Resources office, reported that some improvements to one of the new hiring procedures announced last week are under way. Because completing a review form as previously discussed for every application a manager sees may be an overwhelming task for some areas, Human Resources is looking at the possibility of using one form for each position instead of each application. This proposal will be going through a review and approval process, and Carullo will give updates as they become available. The intent is to improve documentation of hiring decisions.

Managed Care Update

• Karyn Bowie, director of Managed Care, updated the management team on the presence of managed care in our local market and the status of managed care contracting at MUSC.
• The Charleston market includes 458,700 people who are under age 65. Of those, about 182,000 are not covered by a managed care plan. They have health insurance through plans such as Medicaid, traditional fee-for-service plans or the State Health Plan, or they may be uninsured. About 276,000 people are covered by some sort of managed care plan. Bowie said that number may surprise those who’ve heard that managed care has “passed South Carolina by.” In fact, in most urban areas of the state, managed care has a strong presence.
• Of those covered by a managed care plan, about 87,000 are enrolled in an HMO, or health maintenance organization. About 179,000 are enrolled in a PPO, or preferred provider organization.
• HMOs typically require that members choose a primary care “gatekeeper” physician who is responsible for managing their health care, including making referrals to specialists when needed. PPO plans typically contract with both primary care and specialty physicians and encourage their members to choose physicians from that group. Members who do not choose physicians under contract with the plan usually pay a higher percentage of the charges for services.
• MUSC has contracts with many HMO and PPO plans in the area. The HMO plans it contracts with cover 85,000 people. The PPO plans it contracts with cover 145,000 people. This amounts to nearly 85 percent of the total eligible population. Bowie said that our success with contracts indicates consumers want access to MUSC doctors and facilities because of our reputation for high-quality care and our primary care network (Carolina Family Care).
• Current initiatives in the Managed Care Department include:
• Spectrum Health Network. This will be the legal entity that will allow MUSC to work more closely with East Cooper Regional Medical Center and Trident Regional Medical Center and the medical staffs at each facility in contracting with managed care companies.
• Managed Care Task Force. Authorized by the University Medical Associates Executive Committee, this group will give MUSC faculty members more of a voice in managed care contracting activities. It will act as an advisory committee to the Executive Committee on the professional aspects of managed care issues.
• State Health Plan. For some time, MUSC leaders have been working with the State Budget and Control Board to offer employees a health plan that encourages the use of MUSC and MUSC-affiliated providers. In October, MUSC employees will be offered the opportunity to participate in a two-year demonstration project with a new type of state health plan. It will include features such as a gatekeeper physician like HMOs have, but will have more flexibility. For example, members who see a specialist without a referral will be covered for the visit, but will pay a higher copayment than if they had a referral. The plan also will include enhanced preventive, screening and prescription benefits.

Medical Center Human Resources Streamlining Documentation

• Susan Carullo, manager of Employment, Compensation and Employee Relations for the Medical Center Human Resources office, spoke to the management team on the work of a committee looking at how the Employee Performance Management System, or EPMS, form and the position description form might be combined. Carullo said this idea came about during preparations for last year’s Joint Commission on Accreditation of Healthcare Organizations survey when it became obvious that having both forms was cumbersome for managers.
• The committee is currently evaluating whether the EPMS and position description forms can be readily combined by looking at: MUSC and state policies and how various elements of these policies would affect a new combined form; the competency assessment process and documentation needed to comply with JCAHO standards; and documentation needed to comply with the Americans with Disabilities Act.
• Committee members are: Pamela Allison, Ruth Baker, Gaye Chinnis, Susan Carullo, Rosemary Ellis, Eric Frisch, Mary Anne Healy, Joan Janes, Chris Malanuk, Phyllis Malpas, Carol McDougall, Paul Moss, Kim Nilsson, Rhonda Richardson, Eric Rouvalis, Jim Schaffner, Carolyn Viall and Steve Vinciguerra.
• The draft of the proposed combined form includes several sections. The position description duties and, if applicable, performance objectives will be incorporated into the first section, core competencies will fit in the second and behavioral characteristics (the Medical Center’s values of accountability, respect, excellence and adaptability) in the third.
• All employees, both in management and non-management positions, will be evaluated on the core competencies of customer service, compliance, performance improvement and age-specific competencies. Those in management positions also will be evaluated on human resources, leadership and budget and financial management skills.
• The core competencies and behavioral characteristics sections will, under the proposal, be preprinted for convenience. These preprinted core competencies and behavioral characteristics will serve to underscore the priority that we, as an organization, have placed on these particular areas.
• Carullo also said that the sections of the form will be weighted. This means that some sections will count more than others to enable a better representation of an employee’s total performance.
• Challenges faced by the committee include: making sure the project will have enough computer support so that tracking and reporting can be improved; implementing a phase-in plan; gaining state approval for the proposal; educating staff members and managers; and finding how best to incorporate the Clinical Advancement Program into the new process without compromising the CAP.