When two of the most prestigious medical schools in the nation announced plans to establish an alliance of their physicians, it made news headlines. But the goal of that alliance, known as Columbia-Cornell Care, was intended to do more than grab attention--it is a partnership with the goal of ensuring a strong future. In July 1996, the two schools drafted a letter of intent, followed by the signing of an official contract on Nov. 27. That contract created a combined physician organization whose intent is to create a powerful force in the health care marketplace as managed care moves increasingly into the New York City region. "Academic physicians in areas where HMOs already dominate have been less able to determine the conditions under which they practice," says Dr. Herbert Pardes, vice president and dean. "By creating Columbia-Cornell Care, we are getting ahead of the curve."

What does the CCC agreement mean? By partnering with the faculty of another distinguished medical school, P&S is in a favorable position to compete in a rapidly evolving health care environment and to enhance the continued development of educational and research programs. The alliance is intended to create a strong system of support services and practice sites to reduce practice overhead costs through economies of scale and improved management systems. With more than 2,800 physicians in the two institutions, this will enable the network to have competitive strength in the marketplace for contracts with managed care companies and insurance programs. The alliance will enhance opportunities for physician collaboration in designing improved models of primary care service delivery, new treatment protocols for specific diseases, and innovations in medical education and training. Services could include computerized business and medical management systems, marketing, and primary care practice sites.

CCC will build upon the strengths and accomplishments of the Columbia-Presbyterian Physician Network, the managed care service organization for Columbia University's Faculty of Medicine. "We are fortunate that we have experience building a strong unified program going in," says Dr. Pardes. Columbia and Cornell will invest a total of $45 million over the next five years through CCC to enhance physician practices. That investment is mainly for managed care contracting and medical management expenses, related clinical and business information systems, and two primary care demonstration sites. Columbia and Cornell have committed additional capital for primary care and other investments in the two local physician organizations.

The innovative relationship marks the first time two medical school faculties have formed a clinical alliance while their medical schools maintain separate identities. The alliance was announced the same day Presbyterian Hospital, the principal teaching hospital for P&S, and New York Hospital, Cornell Medical College's principal teaching hospital, announced plans to merge. The hospital merger plan does not foreshadow any changes in the research and education missions of P&S.

At the end of fiscal year 1997, more than 1,200 physicians had joined CCC as the alliance moved from the planning stages into operational mode. The search for a president and chief executive officer of CCC ended in the October 1997 with the announcement that Dr. Bruce Spivey would assume that post. Dr. Spivey previously served as president and chief executive officer of Northwestern Healthcare Network in Chicago and was selected to head CCC based on his health care administration experience, which includes establishing and directing one of the largest not-for-profit health care systems in the United States. He is a board-certified ophthalmologist, was the first CEO of the American Academy of Ophthalmology, and is former president of the American Board of Medical Specialties and the California Healthcare System in San Francisco.