Minnesota Attorney General Keith Ellison showed exasperation Monday with the University of Minnesota administration, because it has failed to reach a final master agreement with M Physicians.

In the yearslong saga involving negotiations to reach an operating agreement among the U of M, Fairview Health Services, and M Physicians, Ellison appointed a three-person mediation team last year to bring the parties together. Mediation succeeded in getting the parties to face reality, and they reached a 10-year framework agreement that was unveiled Jan. 26.

Ellison heralded that mediation agreement, because he said it would “secure core funding for the University of Minnesota Medical School, continue high-quality patient care for 1.2 million people a year, and ensure continued world-class research and medical education in Minnesota.”

As part of the January framework deal, the three parties agreed that they would complete talks on three bilateral, definitive agreements by March 31.

In a news release Monday, Ellison noted that Fairview and M Physicians had finalized their stability agreement. “Fairview and the University of Minnesota are working to finalize their academic affiliation agreement in the coming days to allow their important joint efforts in medical education and research to go forward,” Ellison said.

The attorney general’s frustration stems from the fact that the U of M administration hasn’t reached an agreement with M Physicians, an independent entity with about 1,500 physicians.

“This lack of a bilateral agreement between the University [of Minnesota] and the University of Minnesota Physicians does not have to harm the provision of health care to patients, the recruitment and retention of physicians, or the Medical School, provided that all parties agree to work collaboratively and refrain from public criticism or attacks that in the past have had a destabilizing effect on patients, physicians, and funders,” Ellison said in Monday’s release.

That reference was a nod to the explosive rhetoric that came from the U of M administration and Board of Regents in November after Fairview and M Physicians did a deal with the attorney general’s blessing.

At the time, the administration said in a written statement that the “agreement strongly oversteps Fairview and the University of Minnesota Physicians’ authority—and represents a hostile takeover of the University of Minnesota Medical School.”

In a letter to Ellison, the U of M Regents chair and two vice chairs wrote the bilateral deal would make the university physicians “a captive entity of Fairview.” The regents passed a resolution that said the Fairview-M Physicians deal would “improperly usurp the University’s authority.”

The U of M’s perspective on authority, governance, power, and control was spotlighted by Ellison in his Monday statement.

“More than a year ago, I announced the start of the strategic facilitation process to chart a sustainable path for the future of academic and clinical medicine and community health in Minnesota,” Ellison wrote. “Before then and since, University of Minnesota leadership and their team of consultants have pursued a variety of different governance and new control measures over their relationship with Fairview and the University of Minnesota Physicians.”

The attorney general chronicled several strategies that the U of M administration rolled out over a period of years.

U of M’s changing strategies

“These have included proposals to: buy back the Medical Center and other assets from Fairview; engineer a new partnership with Essentia Health to run a combined Essentia and Fairview system; unwind the relationship with Fairview and seek entirely new and different partnerships; and remove University of Minnesota Physicians as the faculty practice group for the Medical School,” Ellison said in his Monday statement.

“During this key period, key Medical School leaders have left the University,” Ellison said. “Minnesotans can assess for themselves the underlying factors that have led to the University’s actions, which now includes the lack of this definitive agreement within the agreed deadline.”

In his two-page statement, Ellison mentioned only one leader by name. “University of Minnesota President Rebecca Cunningham called [the 10-year mediated agreement] a ‘win-win-win’ in public testimony before the Higher Education committees of both houses of the Minnesota Legislature earlier this year,” Ellison said.

It should be emphasized that the three-person mediation team—retired Hennepin County District Court Judge Thomas Fraser and former UnitedHealth Group executives Lois Quam and Dr. Bill McGuire—didn’t vanish after the 10-year framework agreement was achieved in January.

They’ve been working with the parties to help reach the definitive bilateral agreements.

“The University [of Minnesota] is working diligently and remains fully committed to and hopeful that we will forge final agreements with both Fairview Health Services and M Physicians,” said U of M spokeswoman Heather Carlson Kehren.

“Getting the agreements right is what matters most,” she said. “We continue to negotiate in good faith so that we can recruit top faculty, advance discovery and innovation, maintain our accreditation, invest in modern facilities, and educate the health professionals who will continue to ensure the health of all of Minnesota.”

M Physicians’ negotiating posture

Spokesman Connor Myhre said, “M Physicians remains deeply committed to the work of achieving definitive agreements that serve our care teams, our faculty, our patients, and all the communities we serve.”

He said the physicians’ group is grateful for the facilitation from the mediation team. In upcoming negotiations, he said, M Physicians would be “guided by the commitments we made in the mediation settlement agreement and the stability, clarity, and closure it provides for us all.”

Fairview spokeswoman Aimee Jordan said the health system appreciates Ellison’s involvement in the talks and a continued focus on providing stability for patients, providers, and learners.

“Fairview has finalized our agreement with M Physicians, and we have proposed to the University [of Minnesota] a standard agreement that follows the mediated settlement agreement, meets accreditation requirements, and can be executed to ensure continued support of graduate medical education and research,” Jordan said. “We remain ready to move forward on the remaining work to support a strong, sustainable future for care, education, and research in Minnesota.”