Economic stress in higher education
You might think universities would be immune to the financial pressures of the non-academic marketplace. You would be wrong.
Brandeis University is struggling financially, and recently fired their resident string quartet, the Lydian String Quartet* after 40 years, to save $275,000.
Other universities that, unlike Brandeis, have medical schools, are also struggling with their budgets.
“More light has been shed on allegations of a toxic work environment at the University of Virginia School of Medicine and UVA Health.
“About a year ago, surgeons had raised concerns that they were pressured by leadership to upcode in an effort to bring in more money, according to The Daily Progress.
“The news outlet obtained an audio recording from a meeting last November that was attended by surgeons, the department chair, and representatives for the health system’s billing and coding team.
“”You’re going to get in a lot of trouble if somebody tells [a surgeon] you need to bill 99291 on every one of these patients like that,” a surgeon said during the meeting. “That is what gets universities in trouble.”
“”We’re the ones that would get fined and go to jail,” the surgeon said, according to The Daily Progress.
“Surgeons said there was “tremendous pressure” from senior leadership to charge patients more, particularly at the system’s flagship hospital UVA Medical Center in Charlottesville, according to the article. Doctors were told to do so by using the CPT code 99291, which indicates a doctor spent 30 to 74 minutes administering critical care services.
“This code brings in $1,060 and 4.5 relative value units, while a similar code (99232) brings in only $200 and about 1.39 relative value units, the article stated.
“Troubles at UVA Health first came to light in September, when 128 faculty employed by UVA Physicians Group authored a letter of no confidence in UVA Health CEO Craig Kent, MD, and School of Medicine dean Melina Kibbe, MD, calling for their immediate removal.””
That’s a lot more than the quarter million dollars saved by firing the Lydians. But at the end of the day, universities—including state universities—are businesses and answer to bean counters, not academics.
*Full disclosure: my sister was a founding member of the Lydians.
UVA Health Surgeons Sound Alarm on Upcoding
Brandeis University is struggling financially, and recently fired their resident string quartet, the Lydian String Quartet* after 40 years, to save $275,000.
Other universities that, unlike Brandeis, have medical schools, are also struggling with their budgets.
“More light has been shed on allegations of a toxic work environment at the University of Virginia School of Medicine and UVA Health.
“About a year ago, surgeons had raised concerns that they were pressured by leadership to upcode in an effort to bring in more money, according to The Daily Progress.
“The news outlet obtained an audio recording from a meeting last November that was attended by surgeons, the department chair, and representatives for the health system’s billing and coding team.
“”You’re going to get in a lot of trouble if somebody tells [a surgeon] you need to bill 99291 on every one of these patients like that,” a surgeon said during the meeting. “That is what gets universities in trouble.”
“”We’re the ones that would get fined and go to jail,” the surgeon said, according to The Daily Progress.
“Surgeons said there was “tremendous pressure” from senior leadership to charge patients more, particularly at the system’s flagship hospital UVA Medical Center in Charlottesville, according to the article. Doctors were told to do so by using the CPT code 99291, which indicates a doctor spent 30 to 74 minutes administering critical care services.
“This code brings in $1,060 and 4.5 relative value units, while a similar code (99232) brings in only $200 and about 1.39 relative value units, the article stated.
“Troubles at UVA Health first came to light in September, when 128 faculty employed by UVA Physicians Group authored a letter of no confidence in UVA Health CEO Craig Kent, MD, and School of Medicine dean Melina Kibbe, MD, calling for their immediate removal.””
That’s a lot more than the quarter million dollars saved by firing the Lydians. But at the end of the day, universities—including state universities—are businesses and answer to bean counters, not academics.
*Full disclosure: my sister was a founding member of the Lydians.
UVA Health Surgeons Sound Alarm on Upcoding
To add to this:
It was Dr. Donald Berwick while head of Centers for Medicare and Medicaid during the 1st half of the Obama administration who said, repeatedly, that at least 1/3 of Medicare dollars was wasted on unnecessary tests, procedures and drugs that provide no benefit for the patient. Angry Bear. It is even worse with Medicare Advantage.
Most patients do not know or realize when they are being up-coded. The reason for this is trust in your doctor. Why would one go to a doctor if they did not trust their judgement? Plus doctors know many patients do not realize it, And . . . many patients will not ask questions.
There are issues with the cost of healthcare in the US as compared to other countries. Much of it lies with the profit motivation and costs of infrastructure, meds, and other items used in patient care.
I am sorry about the Lydians at Brandeis. Activities such as theirs makes college town life enjoyable. The higher education industry got overbuilt (with a lag) during the rapid increase in student loans. Now that it is quite obvious that many college degrees are not worth (at least from a financial perspective) the out of pockets costs (tuition, student loans, fees, etc.) incurred, enrollment is going down and students do not want to pay as much. Less students coupled with higher education being overbuilt during the boom demand years have led to many if not most schools having to cut back. Plus the administration/student ratio has become bloated.
A better approach would have been to make qualification for student loans merit based, preferably with a rigorous standardized test. I know many will scream discrimination using the standardized test but there was a recent NYT article that showed minorities actually had better chances of enrollment with the standardized test than without it. https://www.nytimes.com/2024/01/07/briefing/the-misguided-war-on-the-sat.html
The country is going to go through many painful cutbacks in many areas. Higher education is just one of them.
You are right of course. Those exposed to a better educational environment will still have access. The rest of them can always clean their toilets and make a good wage to live on.
Twenty and thirty years ago they were discussing the same topic; “the administration/student ratio has become bloated.” It has not changed much since then. After all, Profs and instructors can cut grass, can’t they during their time off? You offer up bromides as to the real issues here.
“a trite and unoriginal idea or remark, typically intended to soothe or placate. ‘feel-good bromides create the illusion of problem solving‘”
Rigorous standardized tests already exist which really do not explain whether a person will be successful in college.
“Staff-to-student ratios still fall short! They offer the illusion of explaining fiscal responsibility, educational quality, and student experience because they superficially imply all students have the same needs. But as needs continue to grow and diversify, these ratios lose their authority.”
Blame it on that. Everyone has an equal opportunity to be successful in grade schools, high schools, and college. Or do they? They all arrive at an important junction in life at 18. What am I going to do the rest of my life? If you have never been exposed to something better, how do you decide. A large portion of our population has not been exposed to something better. Your solution is “take this test” and we will decide what is better for you.
By the way, practice with this brush in a bowl of water, they are going to ask you if you have experience in cleaning. At least then you can show them how you swish the water around. A clear-cut solution, heh?
I would be interested in hearing your solution.
Here is an article on Ohio University faculty versus administration ratio. https://www.ou-aaup.org/news/fewer-faculty-more-administrators It looks like it is still shrinking (i.e. higher proportion of administrators).
I guess you dismiss the results from the article from the NYT that I linked regarding SAT scores and success in college. The predictive ability of the SAT was much better than high school grades.
I am not saying that everyone has an equal opportunity to do well in school but there are some disadvantages that are almost impossible to overcome, at least at the stage of college admissions. It definitely isn’t cost effective to try to overcome disadvantages at that stage of life by providing free college to everyone. I don’t think that it will be possible to eliminate a lot of advantage to many people, many parents work very hard to give their offspring advantages.
I wouldn’t be so dismissive of jobs, employment, and careers that do not require a college education. Most of these jobs are very necessary (as people found out during the Covid lockdowns) even if some of the jobs do not pay that well. And some jobs offer a pathway to college through reimbursed tuition.
Here is an interesting source of information for you to plan your solution. https://nces.ed.gov/programs/coe/indicator/csc/postsecondary-faculty
@Pre,
“Here is an article on Ohio University faculty versus administration ratio.”
LOL! One article on one university. There are 37 public two- and four-year colleges and universities in Ohio, including 14 four-year research universities and 24 state university campuses. Ohio has more than 50 four-year private colleges and universities as well as 23 community colleges and technical colleges. Nevermind the other 49 states and the District of Columbia.
“I guess you dismiss the results from the article from the NYT”
LOL! You guess wrong.
“I wouldn’t be so dismissive of jobs, employment, and careers that do not require a college education.”
LOL! Please point out where I dismissed jobs, employment and careers that do not require a college education. Take all the time you need.
You need to work on your reading comprehension. You’d get an F in my class.