Seattle Cancer Care Alliance and its members — Fred Hutchinson Cancer Research Center (Fred Hutch), Seattle Children’s and UW Medicine — have announced exploration of a plan to redefine our alliance and accelerate the discovery and delivery of lifesaving breakthroughs to our patients. Included in this document are answers to questions you might have about this announcement, including a recent update to add seven new answers to some of your most frequently asked questions. This document will continue to be updated as more information becomes available.
Learn more about the oncology restructure teams.
NEW ONCOLOGY RESTRUCTURE FAQ [As of Nov. 1]
1. How will Fred Hutchinson Cancer Center and Seattle Children’s continue to work together to advance pediatric oncology research?
Through the new research affiliation agreement, Fred Hutch and Seattle Children’s are strengthening our commitments to support and enhance pediatric cancer research across both institutions. We are conducting joint strategic planning in areas such as research initiatives, faculty recruitment and access to research data. Going forward, we will work together to improve processes for facilitating clinical, translational, and basic pediatric cancer research and to expand opportunities for investigators to collaborate in other research areas, such as infectious disease, that ultimately advance science and patient care.
2. What is the current state of cancer pediatric care at Seattle Children’s? How could this change over the next year?
Seattle Children’s will continue to invest in pediatric cancer care and research. Seattle Children’s is excited to welcome Dr. Mignon Loh on December 1 as the head of the Cancer and Blood Disorders Center and Director of the Ben Towne Center for Childhood Cancer Research. Dr Loh will also serve as Division Chief of Pediatric Hematology, Oncology, Bone Marrow Transplant and Cellular Therapy at UW Medicine; a professor in the Department of Pediatrics at the UW School of Medicine; and the Head of the Section of Pediatric Oncology at Fred Hutch.
Currently, inpatient pediatric cancer care (including care provided through the infusion and oncology clinics) takes place at Seattle Children’s on the Laurelhurst campus. Outpatient bone marrow transplant patients receive outpatient care at SCCA in South Lake Union.
When the new Building Care facility opens next year, Seattle Children’s will have new operating rooms, a new Cancer and Blood Disorders Center outpatient clinic, additional inpatient beds and more. Seattle Children’s plans to move the outpatient bone marrow transplant program from SCCA into the Building Care facility, so ambulatory infusion and patient programs will be provided in the newest building.
These changes simplify the model for both clinicians and patients at Seattle Children’s. All of the faculty will continue to be UW School of Medicine faculty who provide care through Children’s University Medical Group. Seattle Children’s patients will receive all clinical care and clinical trials in one location.
In addition, the teams at the Ben Towne Center for Childhood Cancer Research at Seattle Children’s Research Institute and in the pediatric oncology group within Fred Hutch will continue their long-standing work to discover and translate research advances that lead to new cures for children, adolescents and young adults with cancer.
3. How would the restructure advance our commitment to antiracism and improving health outcomes for all populations?
Together through the Fred Hutch/University of Washington Cancer Consortium supported by our NCI cancer center support grant (CCSG), we are already addressing the cancer needs of our community, including cancers that disproportionately affect BIPOC (Black, Indigenous and People of Color) and other underrepresented communities. Diversity, equity, and inclusion (DEI) is a key component of the grant and formalizes the Consortium’s commitment to this work.
We believe the restructure would allow our organizations to benefit from the ongoing DEI work each organization is doing today, enhancing our collective understanding and ability to move our organizations forward. The restructure would further enable us to:
- Better identify and combat healthcare inequities related to cancer screening, diagnosis and treatment and integrate this work into our clinical programs and dashboards, so we can develop the solutions faster.
- Ensure timely access to care, equitable access to clinical trials/therapies, and the best outcomes by following and studying outcomes and clinical enrollment to identify and eliminate disparities.
- Better connect comprehensive research to the adult clinical setting, positioning Fred Hutchinson Cancer Center and UW Medicine to lead the way in applying an equity lens to our strategy, design of research programs, and support of those research programs.
Fred Hutch, SCCA, UW Medicine and Seattle Children’s are committed to DEI and to becoming antiracist organizations. This work is and will remain critical to our missions. We are committed to continuing our DEI work and to foster inclusive cultures that embrace diversity. Becoming anti-racist organizations is not something we have accomplished yet or work that can be finished, but rather something we remain committed to work on and make part of our organizational cultures.
4. How will the strategic plan for the future Fred Hutchinson Cancer Center be developed?
Leadership across Fred Hutch, SCCA and UW Medicine would develop an initial FY23 strategic plan and annual budget for Fred Hutchinson Cancer Center that would guide the organization’s work in the first year. In parallel, these leaders would also develop a process for future strategic planning. The plans would be developed in coordination with UW Medicine leaders and would be informed and reviewed by multiple stakeholders across Fred Hutchinson Cancer Center and other clinically integrated parts of UW Medicine.
The Fred Hutchinson Cancer Center strategic plan would include components specific to research, adult clinical oncology and enabling support (e.g., IT, marketing). The adult clinical oncology program component would be inclusive of all sites of adult oncology care across Fred Hutchinson Cancer Center and UW Medical Center, and this component would be jointly developed by Fred Hutchinson Cancer Center and UW Medicine leadership. Elements of the plan that apply to activities at UW Medical Center would be reviewed by the UW Medical Center Board.
The comprehensive Fred Hutchinson Cancer Center strategic plan would be updated annually, reviewed by the Joint Planning and Oversight Committee (JPOC), a committee comprised of the Fred Hutchinson Cancer Center Board Chair and Fred Hutchinson Cancer Center and UW Medicine senior leaders and approved by the Fred Hutchinson Cancer Center Board.
The adult clinical oncology strategic plan would also become a component of the UW Medicine strategic plan. The UW Medicine strategic plan is refreshed every three years with annual updates and is reviewed by the UW Medicine Advisory Board.
5. How will Fred Hutchinson Cancer Center budget priorities be determined?
Fred Hutchinson Cancer Center leadership would develop the future Fred Hutchinson Cancer Center budget, which would include its clinical and research enterprises, administrative and infrastructure support, and capital. The budget would align with the Fred Hutchinson Cancer Center strategic plan (described in the previous question).
The JPOC would review the proposed Fred Hutchinson Cancer Center budget and help ensure coordination of budgets for the adult clinical oncology program. The Fred Hutchinson Cancer Center Board of Directors would have final review and approval of the Fred Hutchinson Cancer Center budget. The UW Medical Center Board would review the portion of the adult clinical oncology program budget that relates to UW Medical Center activities. The UW Medical Center annual budget is approved by the University of Washington Board of Regents based on recommendations from the UW Medical Center Board and the UW Medicine Advisory Board.
UW Medicine leaders would be formally engaged in the budgeting process through participation in joint budget planning committees and JPOC would help integrate the financial planning for cancer services into the UW Medicine annual budget process to support the cancer programs that are operated by UW Medical Center.
6. Would the restructure have an impact on UW graduate education programs or the faculty’s relationship with them?
Our organizations view education and training as the keys to developing the next generation of researchers and clinicians and central to our missions. UW Medicine currently has nearly 5,000 students and trainees. Some of the UW graduate students are currently based at Fred Hutch for the research experiences and UW Medicine graduate medical education trainees (residents and fellows) would have clinical and research experiences at Fred Hutchinson Cancer Center.
The restructure would not have a direct impact on graduate education programs or the faculty’s relationship with these programs, and the organizations and faculty already collaborate effectively in this area. However, we expect that the integrated nature of our future work as Fred Hutchinson Cancer Center would enhance both research and clinical education programs for students and trainees by providing a structure that would allow us to work better together across disciplines. Consistent with the 1994 UW/Fred Hutch affiliation agreement that remains in place, there are no plans for Fred Hutchinson Cancer Center to develop independent graduate programs.
7. How will faculty titles be affected?
School of Medicine faculty titles would not be changed regardless of where the faculty member is based and regardless of sites of clinical practice. Titles for Fred Hutch scientists would change to Member, Associate Member or Assistant Member to reflect their distinct relationship to and role at Fred Hutchinson Cancer Center. If they are also members of the School of Medicine faculty, their school titles would not change and both the Fred Hutchinson Cancer Center member title and the University of Washington professorial faculty title would be listed.
SECTION I: HIGH-LEVEL OVERVIEW
1. What is being announced?
The founding members of Seattle Cancer Care Alliance are exploring a restructure of their longtime alliance as part of an ongoing effort to improve patient care and more effectively advance a shared mission of diagnosing, treating and pioneering cures for cancer and other diseases. Our plan is to have an adult-focused clinical program led by a newly-created Fred Hutchinson Cancer Center and a separate pediatric clinical program led by Seattle Children’s. These programs would be collaborative and driven by the innovative cancer research at Fred Hutch, UW Medicine and Seattle Children’s.
2. What is Seattle Cancer Care Alliance?
Seattle Cancer Care Alliance was formed in 1998 as a partnership among Fred Hutch, Seattle Children’s and UW Medicine. Over the past 20 years, SCCA has provided care to more than 190,000 cancer patients through nine SCCA-operated treatment centers across Washington state.
3. How will the partnership between members of Seattle Cancer Care Alliance change?
Under the new structure, SCCA and Fred Hutch would merge to form Fred Hutchinson Cancer Center, an independent, private, not-for-profit organization. As part of the merger, all SCCA clinical sites would be renamed “Fred Hutchinson Cancer Center.” Adult clinical care provided through SCCA today would be provided through Fred Hutchinson Cancer Center. Fred Hutchinson Cancer Center would be UW Medicine’s cancer program and operate as a clinically integrated part of UW Medicine, with the senior leadership of Fred Hutchinson Cancer Center becoming members of the UW Medicine senior management team. Members of UW Physicians (UWP), who are School of Medicine faculty, would provide cancer care at Fred Hutchinson Cancer Center and other parts of UW Medicine.
In addition to Fred Hutchinson Cancer Center’s clinical programs (formerly named “SCCA adult cancer programs”), the organization would provide programmatic oversight of the adult oncology clinical programs at UW Medical Center, creating a unified adult oncology program. Seattle Children’s would continue operating independently and be the central site for pediatric cancer care among the organizations.
Our goal in creating a unified, clinically integrated adult oncology program is to provide a seamless and consistent experience for cancer patients and oncologists and across other parts of UW Medicine that interact with the adult cancer program, such as primary care, diagnostics and support services. Over the next few months, we will work to further define what this operational model would look like.
4. What is the vision for Fred Hutchinson Cancer Center, and how would it be different than the current Fred Hutchinson Cancer Research Center?
Fred Hutchinson Cancer Center would result from the merger of Fred Hutchinson Cancer Research Center and SCCA, creating one unified organization. Like both Fred Hutch and SCCA are today, Fred Hutchinson Cancer Center would be an independent, private, not-for-profit organization dedicated to translating scientific discovery into the prevention, diagnosis, treatment and cure of cancer and related diseases. Fred Hutchinson Cancer Center would be UW Medicine’s cancer program and operate as a clinically integrated part of UW Medicine. Fred Hutchinson Cancer Center also would provide programmatic oversight over the oncology services provided by UW Medical Center.
As one organization, Fred Hutchinson Cancer Center would build on the strengths of SCCA and UW Medicine’s nationally recognized adult cancer care programs and outstanding clinical care with Fred Hutch and UW School of Medicine’s leading-edge science. The creation of a single organization that is clinically integrated with other parts of UW Medicine would better position the parties to improve the patient experience and advance the overall mission of UW Medicine and the vision for the new Fred Hutchinson Cancer Center. Furthermore, it would allow us to build an aligned clinical program that improves our ability to serve more patients in our community, in the region and beyond.
5. Why is this restructure being explored?
For the past two decades, SCCA’s members have worked together to create a clinical research and care program that leads the world in helping prevent, diagnose, treat and pioneer cures for cancer. But cancer care and research have changed significantly over the past 20 years, and we now have a deeper understanding of disease and how to prevent, diagnose and treat it. We also have a deeper understanding of our strengths in cancer care and research, as well as the complexity that our current structure creates.
We have had many successes, but also have inadvertently created situations where our individual goals, incentives and strategies sometimes undermined our common goals. This has led to uneven investment in infrastructure to support our growth, variable experiences of accessing cancer services for our patients, challenges for our faculty and staff in coordinating care optimally across the system, as well as confusion about our value proposition to our patients and partners. We believe that our structure must evolve to be more aligned and agile than it is today. Our ultimate goals are to accelerate research, improve patient care and increase every patient’s chance for a better outcome.
6. When would this restructure take place?
In the coming weeks and months, leaders from the four organizations will be discussing the restructure with governing boards, faculty, staff, labor partners, government officials and other stakeholders to inform the plan. Assuming we have obtained all required board and governmental approvals, we anticipate launching Fred Hutchinson Cancer Center in early 2022 without interruption to patient care.
7. How would this restructure improve cancer care and research?
We believe the proposed restructure and arrangement for programmatic oversight of UW Medicine cancer programs would offer greater organizational alignment and agility than our alliance has today. It is being designed to improve our patients’ experience, further reduce the time from research to the delivery of breakthrough treatments and improve the structures that shape our planning and communication to patients, partners and employees and collectively inspire donors to support our mission. We also believe that creating Fred Hutchinson Cancer Center and moving forward under this new structure would further strengthen our organizations’ contributions to Washington state in healthcare delivery, economic growth and a robust life sciences industry.
8. How have events of the past year informed these plans?
SCCA and its members have regularly reviewed and discussed approaches to strengthening our collaboration since we began our shared work 20 years ago. The experiences of the past year – from the COVID-19 pandemic to the nation’s reckoning with racial inequities – have only amplified the urgency and potential impact of evolving our approach.
Each of our organizations rose to the challenges of the COVID pandemic, demonstrating our ability to innovate, uphold our commitment to our patients and advance research even against the backdrop of pandemic restrictions. We led the world in pushing the science forward as quickly as possible – developing new COVID tests and processing tests from across the country, conducting real-time surveillance and providing a leadership role in the clinical trials that resulted in unprecedented speed of vaccine development. We delivered hundreds of thousands of vaccines to our community. By example, we showed what is possible when health organizations rethink their processes and approach.
Equally important, events of the past year have highlighted the deep correlation between social inequities and poorer health outcomes, including for cancer patients. Our organizations are strongly committed to addressing health inequities, so that our research and care benefit all patients. And we seek to build an inclusive FHCC that would embrace the diversity of experience, background and perspectives that drive innovation and support a thriving workforce.
9. Would there be any changes to patients’ current care (such as physician or location of care)?
The new organization would not make changes to patients’ doctors or care teams as part of this proposed transition. Patients will continue to receive the superior care that they have come to expect from us. In fact, through the restructure we expect to improve the patient experience and bring even more innovation to patients and their families.
10. Would there be any changes to the current research programs at the partner organizations?
Under the new structure, the vaccine and infectious diseases, basic and human biology, computational science, and public health research conducted at Fred Hutch would continue as part of Fred Hutchinson Cancer Center, and UW-based research would remain at UW. The partnership between UW Medicine and Seattle Children’s would continue, and Fred Hutchinson Cancer Center and Seattle Children’s Research Institute would also work together to advance pediatric oncology research.
11. When will more information be available?
We will provide regular updates in the months ahead. Our goal is to secure all board and governmental approvals necessary to implement the restructure in early 2022.
12. [Added Aug. 31] How can I get involved in the visioning and building of the new center and structure?
Committees and teams will be reviewing different aspects of the potential restructure and will develop plans for how to engage various stakeholders over the coming months. We encourage all employees to stay involved by following updates shared via email and on their organization’s intranet (e.g., CenterNet, TogetherNet, CHILD, the Huddle) and participating in town halls and other meetings.
SECTION II: PROPOSED RESTRUCTURE
13. Why was it important that the work to date be kept confidential?
Since the fall of 2020, a small group of leaders from each organization (Fred Hutch, SCCA, Seattle Children’s and UW Medicine) has been engaged in discussions to see if the parties could come to agreement on fundamental aspects of the proposed restructure, including:
- Reaching alignment between UW Medicine and Fred Hutch on basic terms of the plan
- Reaching agreement with Seattle Children’s on the withdrawal of its membership interest in SCCA, transfer of the pediatric outpatient Bone Marrow Transplant (BMT) program, and the terms of a new research affiliation between Seattle Children’s and Fred Hutch
- Reaching agreement on the financial terms between UW Medicine and the new FHCC
- Working through a variety of legal and regulatory issues
Because the parties have engaged in similar discussions in the past but have not been successful, it was imperative to ensure we had agreement on key legal and financial issues to ensure feasibility of a new arrangement, before we began to engage oncology clinical leaders in specific aspects to the clinical and research programs, and to brief boards and key stakeholders and going public with the proposed plan.
While we now have alignment on the future high-level vision for FHCC, we have significant work ahead of us to outline what it means to implement that vision, informed by input from our community. We are excited to be at the public stage of this project so that we can continue our efforts with the subject matter experts. We look forward to broader engagement with our community as we build upon the excellence of our current cancer care programs.
14. Why was “Fred Hutchinson Cancer Center” selected as the name?
While Fred Hutch, SCCA and UW Medicine all are well established and respected regional and national brands, Fred Hutch is also recognized nationally and internationally specifically for its work in cancer. Becoming Fred Hutchinson Cancer Center would build on this brand equity and reflect a broader focus on both research and care. Reducing the number of brands will also help eliminate brand confusion for patients, donors, and others in the community that exits today. In addition, the use of the phrase “Cancer Center” is similar to peer organizations, such as Memorial Sloan Kettering Cancer Center, MD Anderson Cancer Center and the Dana-Farber Cancer Institute. Leaders from UW Medicine, SCCA, and Fred Hutch are working in close collaboration on branding and marketing plans for FHCC.
15. After the restructure, will the SCCA brand continue to exist or will it be replaced entirely by FHCC? Will there be a new brand and logo for FHCC?
The newly merged organization would be branded as Fred Hutchinson Cancer Center and continue the clinical programs of SCCA under the new name. We would discontinue use of the SCCA name and brand.
We are working with a brand agency with deep experience in creating award-winning health care brands to ensure that the new brand builds on the brand equity that Fred Hutch, UW Medicine, and SCCA have earned and conveys FHCC’s relationship with UW Medicine as its cancer program. Currently, our plan calls for introducing the new visual and verbal identity in late 2021, so signage and related elements are ready for the anticipated launch in March 2022. A survey of select employees is planned for the fall to engage people in the branding work.
16. What would happen to SCCA’s clinical cancer operations?
SCCA’s adult cancer programs would be part of FHCC. FHCC would be responsible for all inpatient and outpatient adult clinical cancer operations at SCCA currently. SCCA’s pediatric cancer programs in bone marrow transplant would become part of Seattle Children’s.
17. Would there be any change to the number of inpatient beds operated by SCCA (in the future FHCC)?
18. Would FHCC be part of UW Medicine?
Through the contractual management of both its own and the UW Medical Center clinical cancer care programs, FHCC would become a clinically integrated part of UW Medicine. FHCC would be UW Medicine’s cancer program and would work with other parts of UW Medicine to enhance the excellence of the cancer program.
The organizations are actively working on a clinical integration model for FHCC and UW Medicine. The goal of clinical integration is to create a seamless and consistent experience for cancer patients, oncologists and other parts of the UW Medicine health system that interact with the adult cancer program, such as primary care, diagnostics and support services to ultimately make care delivery even more effective and efficient. Through a contractual joint venture arrangement, FHCC would provide a single management structure and accountability for the adult oncology programs within FHCC and those remaining part of UW Medical Center. Notwithstanding its role within the UW Medicine health system, FHCC would be an independently governed and operated organization.
19. Is this transaction and the relationship between UW Medicine and FHCC permanent?
Yes. This proposed restructure represents the reaffirmation of the parties’ joint, long-term commitment to collaborative treatment and efforts to cure cancer.
20. What will the relationship with Seattle Children’s be in the future?
The organizations would continue their close affiliations. The longstanding relationship between UW Medicine and Seattle Children’s, including joint ownership of the Children’s University Medical Group (CUMG), would not change. FHCC and Seattle Children’s would have a research affiliation to collaborate on and advance pediatric oncology research, including commitments by each organization to make additional research investments.
Through the Proton Center, UW Medicine and FHCC would continue to provide radiation therapy services for pediatric patients, and all programs of FHCC would continue to partner with Seattle Children’s to ensure the seamless coordination of pediatric cancer patients transitioning to the adult program as they age. Additionally, adolescent and young adult cancer patients who require services from both pediatric and adult health systems would be coordinated closely between the organizations.
21. What will happen to the Proton Center?
The Seattle Proton Therapy Center became a part of SCCA in February 2021, with complete integration planned for November 2021. This means that the Proton Center would be a part of the new FHCC. The Proton Center also would continue to provide proton therapy to pediatric patients treated at Seattle Children’s.
22. [Added Aug. 31] Under the proposed restructure, what would happen with Project Compass?
Project Compass is a three-year initiative launched by SCCA in November 2020 with the goal of creating a stronger, more sustainable foundation to improve SCCA’s clinical care. Focus areas for the initiative include effective and efficient patient care, employee growth and development and maintaining and maximizing the capabilities of technology platforms and data. SCCA operations, including the Project Compass goals for Fiscal Year 2022 (FY22) and other initiatives that are in progress, are anticipated to continue as usual and on established timelines, but in alignment as appropriate with integration activities related to the SCCA/Fred Hutch merger and clinical integration between Fred Hutchinson Cancer Center and UW Medical Center. Project Compass will help SCCA to enhance organizational impact and, as such, is an important part of preparing for the work ahead, including opening a new building and caring for more patients during and after the potential restructure.
23. Would other legal entities owned or affiliated with Fred Hutch or SCCA be affected by this transaction?
Three entities, which are currently affiliates of Fred Hutch, would become affiliates of the new FHCC:
- The Hutchinson Centre Research Institute of South Africa (HCRISA)
- The Uganda Cancer Institute (UCI)-Fred Hutchinson Cancer Center
- The Seattle Vaccine Research Fund
24. Why didn’t the member organizations structure themselves this way when SCCA was created?
SCCA’s structure was designed in the cancer care and research landscape of the late 1990s. Over the past 20 years, the healthcare environment and pace and nature of research have changed significantly. While SCCA and its members organizations have worked together closely to coordinate adult and pediatric cancer care and advance oncology research, their work has outgrown its original structure. The proposed restructure is the next step in the parties’ relationship and a smart evolution for the dynamic fields of healthcare delivery and scientific innovation.
SECTION III: INTEGRATED ADULT ONCOLOGY PROGRAM
25. [Added Aug. 31] Would this restructure mean that FHCC would be a “covered entity” under HIPAA?
Yes. As a hospital and healthcare organization, FHCC would be a HIPAA-covered entity as SCCA is today and would follow all applicable laws and compliance measures, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
26. [Added Aug. 4] What does it mean to have a clinically integrated adult oncology program?
Today, there are two clinical programs for adult cancer care: SCCA and UW Medical Center. They already operate collaboratively, but they are not as integrated as they could be to optimize and expand the cancer program to serve more patients and increase research activities.
If the restructure plan is approved, FHCC would be UW Medicine’s cancer program, overseeing cancer care at FHCC (including former SCCA adult oncology programs) and with programmatic oversight of UW Medical Center’s adult oncology clinical programs. Under FHCC, there would be one strategic plan for adult oncology that drives how we develop and build programs for the future, as well as a single management structure that would work to deliver care as an integrated system. We are in the process of defining how program oversight will work to both manage and build the cancer programs under the new structure. We are also working with clinical and administrative leaders to inventory and prioritize the areas of greatest need for integration in the short, medium, and long-term. We will engage the oncology community in this process, which will extend well beyond the date of FHCC go live.
27. What does it mean to have a unified adult oncology program?
FHCC would be UW Medicine’s cancer program and would operate as a clinically integrated part of UW Medicine. In addition to FHCC’s clinical programs (which would include former SCCA adult cancer programs), FHCC would provide programmatic oversight of the adult oncology clinical programs at UW Medical Center, creating a unified adult oncology program.
28. What does it mean that FHCC would oversee the integrated adult oncology program?
FHCC would provide a single management structure and accountability for the adult oncology programs within FHCC and those remaining at UW Medical Center. UW Medical Center and FHCC would be separately licensed hospitals. The single management structure would enhance clinical and financial integration while maintaining the UW Medical Center Board’s governance of the UW Medical Center-licensed programs for which it is legally responsible. The organizations are actively working on a clinical integration model, with a key tenet that FHCC would oversee clinical programs as well as the development of new programs across campuses to ensure a seamless experience for cancer patients wherever they access services. In the coming months, we will share more information about this model and how it positions us for future success.
29. What are the benefits of an integrated adult oncology program?
People diagnosed with cancer have an urgent need for the most effective treatment for their disease. Combining UW Medical Center and SCCA’s clinical oncology services into an integrated program under a single management team would lead to many benefits, including:
- Improving the patient experience, including increasing access
- Increasing the number of clinical trials and patients’ access to clinical research
- Accelerating translational oncology research
- Improving the coordination, collaboration and experience of our faculty and staff
- Increasing our capacity and serving more patients
- Reducing barriers to efficiency and a smooth patient experience that result from dual management
- Aligning economic incentives and improving financial performance
- Growing and planning our oncology services in a more coordinated, strategic way
30. How would the oncology programs at Harborview and Valley Medical Center be affected? Would this restructure and FHCC’s oversight over the unified adult oncology program affect their work?
Changes to the programs at Harborview or Valley Medical Center are not planned at this time. The immediate focus of our work is on the current UW Medical Center and SCCA cancer programs. In the future, there may be discussions about whether and how other UW Medicine oncology programs can coordinate most effectively with the integrated adult oncology program.
31. Would UW faculty still provide the clinical care for FHCC?
Yes. UW faculty, both UW-based and Fred Hutch-based, would continue to provide clinical care at both FHCC and UW Medical Center through UW Physicians.
SECTION IV: RESEARCH
32. [Added Aug. 31] What would this mean for grants and contracts? How would this affect how Fred Hutch researchers apply for research funding?
All research activities conducted at Fred Hutch today would continue through FHCC. For current awards and pending proposals, Fred Hutch would work with sponsors to update the awarding entity to Fred Hutchinson Cancer Center. All proposals would be submitted through FHCC.
There would be no change to UW-based research grants. UW-based research grants, facilities and personnel would remain at UW.
33. [Added Aug. 31] When should Fred Hutch researchers start referring to Fred Hutchinson Cancer Center in Request for Application (RFA) grants?
Researchers and staff will be informed when they should refer to Fred Hutchinson Cancer Center in RFA grants. Generally, this is expected to occur in early 2022, shortly after all required approvals are secured, but before the merger of Fred Hutch and SCCA is completed. Once the merger is formally completed, all new proposals thereafter would be submitted through Fred Hutchinson Cancer Center. For then-current awards and pending proposals, Fred Hutch would work with sponsors to update the awarding entity to Fred Hutchinson Cancer Center.
34. [Added Aug. 31] Would Fred Hutch still conduct pediatric oncology research?
Yes, pediatric oncology research would continue at Fred Hutchinson Cancer Center. Fred Hutch and Seattle Children’s have established a research affiliation agreement to collaborate on and advance pediatric oncology research, including commitments by each organization to make additional research investments.
35. [Added Aug. 4] Would this improve administrative/fiscal award management for projects spanning Fred Hutch and UW?
Yes. Research projects that had spanned three institutions (Fred Hutch, SCCA, UW) would only span two (FHCC and UW). This would reduce administrative burden for investigators and their teams while still maintaining and supporting the research teams at both organizations.
FHCC and UW would continue to sponsor research and provide administrative oversight and fiscal management in accordance with their agreements with research funders and their institutional policies. Staff are reviewing how our policies and practices can be improved for projects that will span these organizations.
36. [Added Aug. 4] Would the research conducted at FHCC be solely focused on cancer? If not, how would research in other areas be affected?
All of the research conducted at Fred Hutch today would continue as part of FHCC. The future organization would be just as strongly committed to work in vaccine and infectious diseases, basic and human biology, computational science, and public health. The proposed restructure is being designed to enhance Fred Hutch science overall and position researchers to collaborate efficiently and effectively with UW-based research.
The breadth of Fred Hutch research is a strength: its research in fields outside of cancer enhances cancer research and vice versa. Fred Hutch’s current recruiting priorities and decisions, as well as its investment in the Steam Plant, reflect this. In addition, because it diversifies the grant base and philanthropic efforts, an appropriately broad research portfolio is central to FHCC’s success and growth.
37. Would there be any changes to Fred Hutch’s current research as a result of this transaction?
No. None of Fred Hutch’s current research activities would change upon the closing of this transaction. In addition to cancer-focused research, Fred Hutch’s research programs in basic science, population health, vaccines and infectious disease, and other areas would continue their work within FHCC as they did within Fred Hutchinson Cancer Research Center.
38. Would UW oncology research move to FHCC?
No. UW-based research grants, facilities and personnel would not be transferred to FHCC. FHCC financials would not include UW-based research grants and expenses.
39. [Updated Aug. 31] What would happen to the Cancer Consortium?
Today, Fred Hutch, UW, Seattle Children’s and SCCA participate in the Fred Hutch/University of Washington Cancer Consortium. After the restructure, the Cancer Consortium would remain in place. The institutions participating in it would be the new FHCC, UW and Seattle Children’s. With the approval of the National Cancer Institute, the name of the consortium would change to the “Fred Hutch/University of Washington/Seattle Children’s Cancer Consortia.”
40. How would FHCC and UW Medicine coordinate joint research planning?
Currently faculty at Fred Hutch and UW Medicine collaborate closely on a regular basis in many areas of research and with respect to graduate programs in science. FHCC and UW Medicine plan to establish a Research and Academic Affiliation Operating Council (RAAOC) that would oversee existing academic affiliations between UW Medicine and Fred Hutch that would continue upon formation of FHCC. This oversight would include research planning.
SECTION V: IMPACT TO PATIENTS
41. [Added Aug. 31] How would this impact the “hospital within a hospital” structure?
The “hospital within a hospital” arrangement refers to the 20 SCCA licensed inpatient beds on 8NE at UW Medical Center – Montlake. The new Fred Hutchinson Cancer Center will continue to operate the SCCA licensed beds as a separately licensed hospital within a hospital, under the new name. Patients admitted to UW Medical Center beds specifically for cancer treatment would continue to be admitted to units licensed to, and managed by, UW Medical Center – Montlake.
42. How would this proposed structure benefit patients?
We anticipate many benefits to bringing research and care closer together, including:
• Creating a smoother, more seamless patient experience with greater access to care;
• Increasing the number of clinical trials and access to clinical research;
• Increasing our capacity to serve more patients; and
• Growing and planning our oncology services in a more coordinated, strategic way.
43. How would this restructure accelerate translation of research discoveries to the delivery of clinical care?
Today, patients with a diagnosis for which there is no approved cancer treatment or only partially effective approved treatments have two options: (1) find a clinical trial offering a potential treatment (out of state, if need be); or (2) go without the potentially most effective treatment. Accelerating the translation of discoveries to patients is therefore imperative.
UW Medicine, Fred Hutch and SCCA conduct a large number of cancer clinical trials today. However, the current process to implement a clinical trial across our complex alliance structure is lengthy, cumbersome and resource-intensive, even though we have worked to streamline it as much as possible. The planned restructure would increase patients’ access to lifesaving clinical trials by both increasing the number of enrolled patients and the number of clinical trials we offer as a result of reducing the complexity of our start-up processes. The ability to do more clinical trials and to use more patient data to inform research would accelerate the virtuous cycle of innovation and enhance FHCC’s ability to drive breakthroughs and develop treatments that do not exist today.
SECTION VI: IMPACT TO STAFF/EMPLOYEES
44. [Added Aug. 31] Would this merger affect employees within the public service loan forgiveness program?
Because Fred Hutchinson Cancer Center would be a 501(c)(3) nonprofit organization, it would be a qualified employer under the public service loan forgiveness program.
45. [Updated Aug. 31] What would happen with administrative jobs in similar departments at Fred Hutch and SCCA?
The goal of this restructure is to align our organizations, enable growth and bring research and clinical care closer together — not eliminate positions. Even in areas that have similar functions, the unique emphasis of Fred Hutch and SCCA roles means there are complementary skill sets and expertise. While the new organizational structure for Fred Hutchinson Cancer Center has not been determined yet, we are working on a formal integration plan that will be announced once complete. Fred Hutch and SCCA anticipate that central administrative departments at the two organizations that have common functions (such as Government Relations, Finance, Communications, Legal, IT, Philanthropy, and DEI) will be integrated into single departments within Fred Hutchinson Cancer Center.
46. [Added Aug. 4] Why wasn’t the announcement shared first with faculty and staff?
Because of the nature of the announcement and the number of people involved, we wanted to make sure all of our stakeholders heard the same information directly from us, which meant closely coordinating the announcement timeline. This was especially important not only for the 40,000 faculty and staff across Fred Hutch, SCCA, Seattle Children’s and UW Medicine, but also for our patients. We believe that it is important to reassure our patients that there would be no disruption to their care as a result of the announced exploration.
47. [Added Aug. 31] How would the merger affect Fred Hutch’s Integrated Research Centers (IRCs)?
Fred Hutch operates IRCs for immunotherapy, pathogen-related malignancies, and translational data science. IRCs, which are complementary to Fred Hutch’s scientific divisions, are designed to accelerate discovery by promoting cross-disciplinary and cross-divisional collaboration in research areas where there is great potential for Fred Hutch to have transformative impact. The proposed restructure would not directly affect these IRCs. Just as the restructure is expected to enhance the integration of research and clinical care, we anticipate that it will enhance the translational research of the IRCs. For example, the proposed restructure should streamline and accelerate the Immunotherapy IRCs work with SCCA to start clinical trials.
48. [Added Aug. 4] Will staff have to go through a rehire process?
No, SCCA and Fred Hutch staff will not have to apply for their jobs.
49. [Added Aug. 4] Will Fred Hutch/SCCA employees become FHCC employees, or will they be UW employees?
If the plan to merge Fred Hutch and SCCA is approved, the employees at Fred Hutch and SCCA would become employees of FHCC. Fred Hutch and SCCA employees would not become employees of the University of Washington (UW), and UW employees would not become employees of the new FHCC as part of this transaction.
50. [Added Aug. 4] Will SCCA and/or Fred Hutch-affiliated staff have to change email addresses?
If the plan is approved, SCCA employees would become FHCC employees, and there would be a process by which email addresses would be updated. At this time, we anticipate that Fred Hutch staff will keep their current email addresses.
51. Would there be any employment changes for staff because of this restructure?
Yes. When Fred Hutch and SCCA merge, the employees at Fred Hutch and SCCA would become employees of FHCC. We are determining how this change may affect individuals’ compensation, benefits and reporting relationships now and will share information as soon as possible. We do not anticipate significant changes.
In addition, we do not anticipate that any Fred Hutch or SCCA employees would become employees of UW, or that UW employees would become employees of FHCC.
52. Are the organizations planning layoffs as part of this restructure?
No layoffs are planned at this time. Our ability to achieve our mission depends on the talent and dedication of our faculty, staff and employees. While we can’t promise that the restructure won’t result in organizational job changes, any layoffs or reorganizations would be handled transparently and with sufficient notice, consistent with applicable policies, procedures and collective bargaining agreements.
53. [Added Aug. 31] Would the merger require a new Federal Employer Identification Number?
Under the corporate statutes, Fred Hutch is merging into the SCCA corporation. Fred Hutchinson Cancer Center would operate under the Federal Employer Identification Number (FEIN) currently held by SCCA. The FEIN (as seen on W2 tax forms) would remain the same for current SCCA employees and change for current Fred Hutch employees.
SECTION VII: FACULTY
A. Faculty in the adult clinical program
54. Will this proposed transition result in any changes to oversight of faculty?
School of Medicine faculty who provide cancer care would continue to be accountable to the chair and division head of their UW School of Medicine department. They would also have accountability to the adult cancer program leadership. If faculty are Fred Hutch-based, they would also report to their division leadership at FHCC as they do today at Fred Hutch.
55. Will it affect faculty members’ roles as medical staff of UW Medical Center or SCCA?
Faculty members who provide adult cancer care are usually on the medical staffs of both UW Medical Center and SCCA. In the future, they would be on the medical staffs of both UW Medical Center and FHCC. SCCA medical staff membership would transition to FHCC membership, and faculty would not need to reapply for appointment to FHCC medical staff.
56. Will there be changes to the medical leadership structures at UW Medicine and SCCA that affect faculty?
The creation of a clinically integrated adult oncology program under the management of FHCC would impact how the separate oncology programs are managed today. If there are changes to the medical leadership structure, UW Medicine and FHCC would work together with FHCC and UW Medicine medical staffs to ensure a model that would position the organizations for the greatest success.
57. Will this affect roles of faculty members who serve in clinical leadership positions?
Individuals who serve as medical directors for any parts of the adult cancer program would serve in those roles for care provided at FHCC sites of care and UW Medicine sites of care. They would report to the Chief Medical Officer of FHCC for their medical director roles within the adult cancer program. For their activities at other UW Medicine sites of care, they would also report to the Medical Director of the UW Medicine facility. This reflects the new alignment of the adult clinical cancer program.
58. Will faculty members have to move their sites of clinical work?
Faculty would continue to provide care at the sites where they provide care today. In the future, as we integrate programs, build programs and make enhancements, sites of practice may change. Faculty leaders in affected areas would be involved in these decisions.
59. Will any faculty of a School of Medicine department who are UW-based today change to FHCC-based status?
Today, faculty members in adult cancer care and research are either “UW-based” or “Fred Hutch-based.” What this means is described in the next question. Decisions as to whether a faculty member is Fred Hutch-based or UW-based are made by the School of Medicine and Fred Hutch on a case-by-case basis at the time a faculty member is recruited and hired. This would continue when FHCC is created. In a few Department of Medicine divisions, faculty who are UW-based may in the future be offered the opportunity to become Fred Hutch-based, depending on adult cancer program development. The proposal envisions this would be a shared decision made by the School of Medicine department chair or division head, the leader of the FHCC division in which the faculty member would reside and the faculty member.
60. What is the difference between Fred Hutch-based faculty and UW-based faculty?
All School of Medicine faculty, regardless of whether Fred Hutch-based or UW-based, hold appointments in their particular UW School of Medicine department. For those who engage in providing clinical care to patients, the individual also is a member of either UW Physicians (UWP) or Children’s University Medical Group (CUMG), the faculty practice plans. The key differences between Fred Hutch- and UW-based faculty are as follows:
|UW-based UW SoM Faculty||Fred Hutch/FHCC-based UW SoM Faculty|
|Compensation||Yes, from UW and sometimes UWP||Yes, from Fred Hutch and sometimes UWP|
|Retirement Program||Yes, from UW and sometimes from UWP on that portion of compensation paid by UWP||Yes, from Fred Hutch, and if paid by UWP, from UWP on that portion of compensation paid by UWP|
|Professional Liability Coverage||From UW||From Fred Hutch|
|UWP Long Term Disability Coverage||Yes||Yes|
No changes are anticipated to the structure outlined in the table above as part of this transaction.
61. Are there other effects of the transaction for faculty who provide cancer care?
FHCC would be a clinically integrated part of UW Medicine. FHCC would be UW Medicine’s cancer program, and all faculty engaged in cancer care would be a part of the FHCC-led adult clinical cancer program.
62. Will this transaction have any impact on the structure of the UW School of Medicine?
63. Will this transaction have any impact on the structure of departments in UW Physicians?
64. How will faculty recruitment and hiring for the integrated adult oncology program work after FHCC is formed?
The UW School of Medicine departments and divisions would continue to recruit faculty who provide cancer care. In doing this, they would work in close coordination with FHCC. Who is involved in the recruitment would depend on variables like where the new faculty member would be based, what activities they would be engaged in and who is contributing to the recruitment package.
65. What are the implications of this transaction on faculty compensation?
The amount of faculty compensation and sources of pay would not change as a result of this transaction. In the future, it is possible that new forms of incentive may be developed for faculty who provide oncology care. Faculty leaders would be involved in decisions about incentive plans.
B. Faculty impacted by the transfer of the pediatric outpatient BMT program
66. For faculty who provide care in the pediatric BMT program, what will change?
Fred Hutch-based faculty who provide care under the pediatric BMT program would move from UW Physicians membership to become professional members of Children’s University Medical Group (CUMG). CUMG is the faculty practice plan for physicians and providers who primarily care for pediatric patients.
67. Does this mean that UW School of Medicine Fred Hutch-based faculty will become employed by Seattle Children’s?
No. Faculty would continue to be members of the School of Medicine faculty and would continue to be compensated and supported by Fred Hutch as part of the established arrangement between Fred Hutch and the School of Medicine. No faculty would become employed by Seattle Children’s as a result of the pediatric BMT program transaction.
68. Would this proposed transition result in any changes to faculty oversight?
Generally, no. Faculty oversight would remain the same. Faculty would continue to report to their School of Medicine department chair and division head and also to Seattle Children’s leadership. For their clinical practice at Seattle Children’s, they would be under the oversight of the Seattle Children’s medical director for clinical practice at Seattle Children’s and required to comply with the Seattle Children’s medical staff bylaws. Faculty who serve in administrative roles at Seattle Children’s would report to Seattle Children’s administrative leadership for those activities.
69. What is the faculty member’s relationship to CUMG?
Each faculty member would move from UW Physicians to CUMG and become a professional member or associate professional member of CUMG. Faculty are required to comply with CUMG policies related to documentation, billing and compliance. Faculty would not receive compensation from CUMG.
70. Will faculty compensation change?
Generally, no. Most of the involved faculty receive all of their compensation from Fred Hutch today. Those few who receive compensation that is split between UW Physicians and Fred Hutch would move to total compensation by Fred Hutch. The amount of gross compensation would not change. Those moving away from UW Physicians compensation may have some small adjustments related to the change in retirement benefit programs away from UW Physicians. Once the UW Physicians compensation is shifted to Fred Hutch, paychecks would align with Fred Hutch’s compensation practices.
71. Will all of the faculty who provide clinical oncology care to pediatric patients be moving to Fred Hutch-based status?
No. The decision as to whether a faculty member is “Fred Hutch-based” is made at the time a faculty member is hired. Any changes into or away from Fred Hutch-based status is a joint decision of the UW Medicine CEO and the Fred Hutch CEO.
SECTION VIII: PHILANTHROPY
72. [Added Aug. 31] Would this affect the Cancer Center Support Grant (CCSG) that the Fred Hutch/University of Washington Cancer Consortium receives? If so, how?
Today, Fred Hutch, UW, Seattle Children’s and SCCA participate in the Fred Hutch/University of Washington Cancer Consortium, which is supported by the CCSG. After the restructure, the Cancer Consortium would remain in place. The institutions participating in it would be Fred Hutchinson Cancer Center, UW, and Seattle Children’s. With the approval of the National Cancer Institute, the name of the consortium would change to the “Fred Hutch/University of Washington/Seattle Children’s Cancer Consortia.”
The new Fred Hutchinson Cancer Center would make the CCSG award application stronger because research and clinical operations would be more tightly integrated. The potential restructure would not change the CCSG renewal schedule.
73. [Added Aug. 31] Would Fred Hutch’s 501(c)(3) status change?
No. Once merged, Fred Hutchinson Cancer Center would be an independent, private, 501(c)(3) organization, just as Fred Hutchinson and SCCA are today. We expect donations to continue to qualify for tax deductions for the donor, as is the case for donations made to Fred Hutch and SCCA today.
74. Who would be responsible for oncology-related fundraising?
As UW Medicine’s cancer program, FHCC would be responsible for all oncology-related fundraising. Total giving to FHCC would be counted in UW Medicine Advancement’s annual fundraising totals. We anticipate that, by eliminating confusion among donors about how to best support cancer work at three distinct organizations, the unified FHCC would inspire increased philanthropy for both cancer research and patient care.
75. How would the funds be used?
Philanthropic funding would be used to support and enhance cancer research and patient care, regardless of where the cancer program activities are located.
76. How would this announcement affect current and/or future philanthropic support to the member organizations?
We are grateful to all those who support Fred Hutch, UW Medicine, Seattle Children’s and SCCA. During this planning phase, there won’t be any change to how philanthropy is handled across the organizations. We remain committed to ensuring every gift advances our shared commitment to helping prevent, diagnose and treat cancer and ultimately, discover cures – regardless of which organization receives the donation.
We will continue to communicate with donors throughout this proposed transition about changes to how philanthropy would be managed under the new structure.
77. How would specific areas of giving be impacted?
We hope all donors will continue to support the research and projects that are most important to them. During this proposed transition, there won’t be any impact on the areas donors are currently supporting.
SECTION IX: FHCC GOVERNANCE, MISSION & EXECUTIVE LEADERSHIP
78. How would FHCC’s and UW Medicine’s missions complement one another?
The organizations’ missions are complementary. UW Medicine’s mission is to improve the health of the public. The mission statement for FHCC, which is in development, would reflect FHCC’s focus on the advancement of science, the translation of discoveries from bench to bedside, and the prevention, treatment and cure of cancer and related diseases.
79. What would the executive leadership structure at FHCC look like?
Leaders involved in the proposed transition are discussing the FHCC structure now and will share more information as decisions are made. The parties have proposed that FHCC’s structure would include a president and director, who is the current president and director of Fred Hutch. FHCC’s executive clinical leaders would include scientific, clinical and administrative leaders from both Fred Hutch and SCCA. As part of clinical integration, SCCA’s current president and executive director would serve as the FHCC Executive Director for Clinical Care, reporting to the FHCC president and director and the UW Medicine President of Hospitals & Clinics.
80. Would FHCC have a new board?
Yes. The Fred Hutch and SCCA boards would be retired when Fred Hutch and SCCA merge. The plan currently proposes FHCC would be governed by a new, 12-member board of directors. Eight members would be community members, and four members would be ex officio members representing leadership of FHCC and leaders of UW Medicine. In addition, the plan proposes FHCC would have a Board of Stewards that would serve as advocates for FHCC and its mission and provide advice to FHCC management and the FHCC fiduciary board in areas such as science and technology, philanthropy and community relations.
81. How would the FHCC Board relate to the UW Board of Regents?
The plan currently proposes that two members of the FHCC board would serve on the UW Medicine Advisory Board.
SECTION X: BILLING & PAYOR RELATIONS
82. Would there be changes to the way services are billed today?
In general, no. Hospital facility-based oncology care would be billed by and for the hospital that provides the care (FHCC or UW Medical Center). All professional services would be billed by UW Physicians (or Children’s University Medical Group for pediatric care).
83. How would payor contracting work under FHCC?
Both UW Medicine and FHCC would directly participate in the development of the adult oncology care contracting strategy and payor negotiation process. As a clinically integrated enterprise, both UW Medicine and FHCC would have a contracting office. Generally, as contemplated, UW Medicine would take a lead role in value-based payment arrangement payor contracting negotiations (e.g., ACN/CIN arrangements) as well as payor contracting negotiations for UW Medical Center, including oncology services, provided at UW Medical Center. FHCC would lead oncology-only payor contracting negotiations for services provided by FHCC.
UW Medicine and FHCC would rely on their respective strengths to ensure that patients have access to the most current cancer care research and techniques, as well as value-based programs that support patient-centered care with the right provider at the right time.
84. What would happen to SCCA’S PPS exemption?
Subject to any necessary regulatory approval, FHCC would retain SCCA’s Prospective Payment System (PPS) exemption.
85. Would FHCC participate in the 340B drug pricing program?
SCCA does not participate in the 340B program today. UW Medical Center does. This restructure would not contemplate an immediate change.
86. Would there be a change to commercial payor rates and/or the rates that patients incur for cancer care?
Leaders involved in FHCC planning are strongly committed to improving the quality of care and making cancer care as cost-effective as possible. Rates charged for cancer care at FHCC and UW Medical Center would continue to be negotiated with payers through the standard contracting process, so they would change in the ordinary course but not directly as a result of the restructuring.
SECTION XI: FINANCIAL RELATIONSHIP
87. What would be the financial relationship between FHCC and UW Medicine?
The organizations have proposed a funds flow arrangement that would support the shared objectives of this transaction, align the parties’ economic interests over the long term and reflect the economic contributions to the integrated adult oncology enterprise. The model allocates the combined profitability and cash flow of the integrated adult clinical oncology program.
88. How would existing funds flow arrangements between the parties’ work?
Fred Hutch and SCCA have funds flow relationships with UW and UW Medicine in many areas outside the integrated adult oncology program (such as graduate education, faculty recruitment and salary support, shared services, clinical department funding, healthcare systems integration and leased staffing). Unless the organizations agree otherwise, these funding and service plans would not change as a result of this proposed restructure.