After struggling for months with wobbly finances and internal dissension, the director of UCLA Medical Center announced Tuesday that he will leave his job to take a top post at the University of Kentucky's medical center.
Dr. Michael Karpf, 58, has been with UCLA since 1995 and oversaw the school's three hospitals and 18 primary-care clinics. UCLA officials said Karpf's job will temporarily be filled by a staff member of the Hunter Group, a consulting firm that issued a withering report on UCLA Healthcare's finances in March.
For now, at least, members of the consulting group will be filling three of the top four slots in UCLA's health care system, whose Westwood medical center is considered among the best in the nation. The Hunter Group, which has a reputation for aggressive cost-cutting and staff reductions, is on track to earn at least $3 million for its consulting and management work at UCLA.
In its March review, the firm found problems ranging from inconsistent billing and plummeting revenues to a disorganized administration in which job duties overlapped.
The group recommended cutting 475 jobs over the next three years to save $31 million and provoked the ire of physicians by suggesting that they need to work harder and see more patients.
Some doctors suggested that the fees paid to Hunter would be better spent shoring up the system's finances.
In April, shortly after the report was issued, UCLA's vice chancellor for finance and budget, Steven A. Olsen, refused to say whether Karpf would remain in his position.
Through a spokeswoman, Olsen declined to comment on Tuesday.
Karpf, whose departure date isn't set, has an annual base salary of $441,000. He was recently criticized by nurses and doctors for accepting a bonus while overseeing job cuts.
On Tuesday, Karpf said he had "absolutely not" been forced to leave his post. Rather, he said, the University of Kentucky had made him an offer he couldn't refuse.
Karpf said that the appeal of his newly created job as executive vice president of health affairs is that he will have a more hands-on role in overseeing university health clinics that care for much of Kentucky's rural population.
"We were out there this week. Driving through the horse country was just breathtaking," Karpf said. "The person who ran the search committee has a horse farm, and my wife has already picked out the name for her horse."
Karpf is from Philadelphia and worked for 16 years at the University of Pittsburgh before coming to UCLA.
Karpf staunchly defended his work there, saying he helped the system survive numerous challenges in recent years and find the money to rebuild two UCLA hospitals, in Santa Monica and Westwood. Both are still under construction.
"I've got done what I set out to do here," Karpf said.
One of the problems Karpf faced was filling the UCLA health care system with patients.
The system was one of many health care providers in the huge Southern California market and often did not bring in the same kind of profits as other UC campuses, such as UC Davis or UC San Francisco.
Karpf tried to expand UCLA's reach into the West Los Angeles market by integrating Santa Monica Hospital Medical Center into the UCLA system in the mid-1990s and also pushing for a network of primary-care clinics.
Though UCLA eventually succeeded somewhat in attracting new patients, its primary competitor, Cedars-Sinai Medical Center, grew even faster, according to the Hunter Group.
At the same time, the amount of money that health insurance providers were reimbursing doctors was falling, meaning hospitals were taking in less money and could support less staff.
In 1999, Karpf had to cut about 50 positions. Then, in the last 18 months, he had to cut 120 to 130 more jobs through attrition.
"Very few people were actually let go," said Karpf, adding that the medical center was focused on reining in costs "before [the Hunter Group] got here."
Lee T. Todd Jr., president of the University of Kentucky, said the Hunter Group's findings about UCLA initially concerned him, but his fears were overcome because the consulting group endorsed Karpf as a candidate.
"We got a strong recommendation from the Hunter Group about Michael's experiences, so I felt comfortable with him," Todd said.
"I felt comfortable with what they said about Karpf's schools."
Times staff writer Charles Ornstein contributed to this report.