When the National Center for Healthcare Leadership selected four sites for its new pilot project in graduate healthcare education, it gravitated toward big universities with well-established reputations in the field.
That's no surprise, industry observers say. After all, the NCHL was created by top officials of big, well-established healthcare systems such as the Henry Ford Health System in Detroit and the UAB Health System in Birmingham, Ala.
The Chicago-based NCHL said it is a coincidence that seven of the group's 17 board members either graduated from or worked as faculty or administrators at two of the center's four newly named pilot sites-the University of Michigan in Ann Arbor, the sixth-largest graduate healthcare program in the nation in terms of students; and the University of Minnesota in Minneapolis, one of America's original programs in health administration.
Marie Sinioris, president and chief executive officer of the NCHL, said the selection process, based on a lengthy series of criteria, was fair and entirely independent. The NCHL board was not involved in a review of applications by six outside experts, she said. She declined to provide any information on how many schools applied for the project, saying it might embarrass programs that did not make the cut.
"It was a rigorous selection process and a totally independent committee," Sinioris said. "These criteria were believed to give us the opportunity to have a high probability for success in the demonstration project. I feel 100% comfortable."
Critics have charged that the NCHL's principal goal is to protect the status quo by supporting big master's of health administration programs that already enjoy the lion's share of resources (Jan. 19, p. 6).
While about 40% of the 17-member NCHL board had links to those two schools, another member, Leo Greenawalt, has a less-direct, geographic connection to the third big institution selected as a pilot site-the University of Washington, Seattle. Greenawalt is president of the Washington State Hospital Association.
The only pilot site without any clear connection to board members is Simmons College in Boston, which has just four full-time faculty members and a roster of about 40 students in the graduate program in healthcare administration.
Sinioris said her organization expects to spend approximately $350,000 on the demonstration project, which will last anywhere from 18 to 24 months as the four schools work with the NCHL and outside consultants to try to develop new models for course work and other related assignments to improve graduate education.
Gary Filerman, an outspoken NCHL critic who is chairman of health systems administration at the School of Nursing & Health Studies at Georgetown University in Washington, said he suspected that only a small group of schools even applied for the demonstration because of the modest stipend of $10,000 for each faculty project coordinator at the four sites. "Look," he said, "foundations have given this organization hundreds of thousands of dollars with which to implement these programs, and the organization turns around and offers this insignificant amount? Most of (the $350,000 total) will go to consultants."
Others outside the organization endorsed the selection of the four pilot sites. "I haven't heard any concerns," said Lydia Reed, incoming president and CEO of the Association of University Programs in Health Administration, a professional organization of top educational leaders. "This is a fairly balanced list of programs, and it's geographically well-balanced. You also have a program like Simmons, which is small but innovative and much less traditional than Michigan, Minnesota and Washington."
Thomas Dolan, president and CEO of the American College of Healthcare Executives, which has clashed in the past with the NCHL and now has its own curriculum project under way with AUPHA, also endorsed the selection. "These are four good programs," he said.
Myron Fottler, a professor and executive director of health services administration programs at the University of Central Florida in Orlando, who has been critical of the NCHL in the past, said it came as no surprise to him that the NCHL chose well-established programs.
"I guess I would have been shocked if Michigan didn't get it," said Fottler, whose school did not apply. "Michigan and Minnesota are obvious choices because people at the (NCHL) have strong Michigan and Minnesota connections. That's pretty obvious."
Gail Warden, the NCHL's chairman, earned a master's degree in healthcare management from the University of Michigan. He retired last year as president and CEO of five-hospital Henry Ford Health System. Another member of the board served as an assistant dean at Michigan. Two members of the NCHL's liaison board also received advanced degrees from Michigan.
In addition to the regular and adjunct board members with ties to Minnesota and Michigan, the board's senior adviser, John Griffith, has worked at the University of Michigan for more than four decades and now serves as a professor in the School of Public Health's Department of Health Management and Policy.
Three members of the board earned degrees at the University of Minnesota. They are: David Fine, CEO of the UAB Health System, who last week was named CEO of St. Luke's Episcopal Health System, Houston; Janet Porter, associate dean of executive education at the University of North Carolina at Chapel Hill's School of Public Health; and William Dwyer, vice president of strategic relationships at Cerner Corp. A fourth, Marla Salmon, a dean at Emory University in Atlanta, served as the head of the University of Minnesota's public health and nursing schools.
G. Ross Baker, an NCHL board member and associate professor at the University of Toronto's Department of Health Policy, Management and Evaluation, discounted any connection between board members and the schools selected for the projects. "In fact, (the four schools) add a lot of credibility to the process," he said. "These are places that are already on the cutting edge. If anything, this will help create new standards for the rest of the schools to catch up to."
Porter, who taught at the University of Minnesota after earning an MBA and a doctorate there, rejected the idea that the board influenced the selections. The pilot sites, she said, "represent the incredible diversity of the field of health services administration: small, education-oriented programs and large research-oriented programs from Boston to Seattle" that offer "full-time degrees to day students and part-time degrees to working professionals in evening programs."