Funds flow in academic neurology

Funds flow arrangements define the financial relationships between departments, medical centers, and university entities within a coordinated academic health system. Although these funds flow frameworks differ, common themes emerge including those that are unique in their influence on academic departments of neurology. Here, we review various funds flow models and their application. Four typical models are described, highlighting the advantages and disadvantages of each for neurology, keeping in mind that most academic health systems use a hybrid model. Several considerations are important when neurology departmental leadership participates in crafting or revising of these funds flow agreements, including choice of benchmarking targets, planning and funding for future growth, demonstrating value, and supporting nonclinical missions including education and research. The American Academy of Neurology Academic Initiative aims to continue to help academic departments nationally understand these issues and define funds flow arrangements that incorporate the unique characteristics of our specialty and allow us to provide outstanding care for patients while supporting the broad missions of neurology departments.