Starting January 1, Columbia University is restructuring its affiliation with Harlem Hospital. The Ivy League school will no longer be the chief employer of physicians at the hospital. However, Columbia’s academic and research affiliation with Harlem Hospital is not changing.

The new affiliation structure is similar to the relationship Columbia has long had with several other affiliated hospitals. Physicians at Harlem Hospital will continue to have Columbia faculty appointments.

In essence, nearly 600 people will be laid off by Columbia and employed the very next day by the new affiliate, Physicians Affiliate Group of New York (PAGNY).

“Any physician that’s on the payroll will have their job January 1,” said Doug Levey, executive director of community affairs for Columbia Medical Center. “Harlem Hospital remains a clinical training site for medical students and other trainees at Columbia. We are as committed as ever to the Harlem community.”

Leavy said that the change is just an affiliation agreement, and patients should not see a difference in services at the hospital. Doctors at Harlem Hospital will receive their paychecks from PAGNY. The change was made by the New York City Health and Hospitals Corporation, which said the new healthcare reform is playing a role.

“HHC is looking to better align our physician services with the direct care delivery mission of the public hospital system,” said HHC spokeswoman Ana Marengo. “One concern that we are addressing is the need to consolidate our many affiliate relationships to a fewer number to strengthen our capacity for fast changes being demanded by healthcare reform without having to engage in protracted negotiations with an unmanageable number of physician organizations.”

Marengo added that some of the demands for healthcare reform include implementing improvements in care coordination, care management and the efficiency of care delivery and new reimbursement models that will be tied to quality outcomes.

PAGNY is also taking over at Coney Island Hospital and currently manages doctors at Lincoln Medical and Mental Health Center in the Bronx.

Harlem Hospital did not respond to phone calls for comment at press time.

With a change in affiliates comes some controversy. Threatening to strike, doctors at Harlem Hospital are not happy with losing pension benefits that Columbia previously provided. Doctors are also upset at PAGNY because their children will no longer receive free tuition at Columbia University and also half off at other colleges.

“As Doctors Council union leadership concedes in its recent message to its roughly 200 members at Harlem Hospital, most of the outstanding compensation and benefit issues have been resolved between the union and the employer, the Physician Affiliate Group of New York, P.C. (PAGNY), and negotiations have been proceeding,” said HCC in a statement. “Nonetheless, HHC will make the necessary arrangements to keep essential services running at Harlem Hospital in the event of a strike and will do all that is possible to limit the impact to our patients.”