Health Care
Changes evident in expansion around the area
While some parts of the business world have been hard hit in 2008, health care was one of the few sectors to have escaped relatively unscathed–at least in North Texas.
Some areas in health care were affected by the economic fallout that marked the latter half of the year, but area hospitals and health care systems have been opening new buildings, expanding services and broadening their scopes to provide for those in Tarrant County at the same time. Elective procedures were put off or cancelled as people began to feel the impact of the declining economy, and some were forced to forego expensive medications or primary care because of rising costs, but the new presidential administrationÂ’s promise to revamp health care has offered many a glimmer of hope.
It’s still uncertain how President-elect Barack Obama’s proposed government-backed health care available to everyone could affect how the industry operates, but 2008 was marked by a still significant number of Americans without health insurance–roughly 43.1 million, according to the Centers for Disease Control and Prevention, including one-quarter of Texas residents. A study published in 2008 in the journal Health Affairs estimated that people uninsured for any part of 2008 spend about $30 billion out of pocket for health care and receive about $56 billion in uncompensated care while uninsured, including about $42 billion from government programs, making the uninsured a weighty economic issue.
Locally, hospitals and health organizations are growing rapidly to keep up with Tarrant County population growth and increasing medical needs. HereÂ’s a look at the past year and a brief preview of changes to watch for in 2009.
Baylor All Saints Medical Center
Perhaps the most obvious change at Baylor All Saints Medical Center in Fort Worth this year was the opening of the Paul and Judy Andrews WomenÂ’s Hospital, which started servicing women and infants in the late spring. Prior to opening the hospital March 31, Baylor All Saints averaged about 120 to 130 births per month, said Steve Newton, president of Baylor All Saints Medical Center. In just a few months that number jumped significantly, going as high as more than 500 births in one month. The year also saw a 48 percent growth in the centerÂ’s transplant volume, including transplants for the kidney, liver and pancreas, which makes it appear to be the fastest-growing transplant program in the U.S., Newton said. Baylor All Saints also debuted a skull base surgery center to tackle tumors at the base of the skull that were formerly considered inoperable and opened all of the beds on its new oncology unit.
While this year was significant for its “bricks and mortar” expansions, 2009 will build on that foundation. The cardiovascular services earned a Cycle II Chest Pain Center Accreditation, and early 2009 should see the opening of a $12 million Center for Invasive and Non-Invasive Cardiology. The emergency department at Baylor’s Southwest campus currently is undergoing an expansion to double in size as well to service the growing number of patients in southern Tarrant County and the people who have to skip primary and preventive medicine due to the economy, Newton said. By growing the necessary and routine services for patients and pursuing smaller services that have huge impact, like the transplant services, Baylor is pushing Fort Worth as a medical community, Newton said.
“We feel very strongly that patients don’t have to leave Fort Worth to get world-class health care,” he said.
Cook ChildrenÂ’s Health Care System
Cook Children’s Health Care System used to have the customary mission and vision statement that are almost mandatory for any organization these days. This year, Cook Children’s replaced its statements by bringing in what it calls its “Promise,” which clearly explains what the organization wants to do for its North Texas community, said Rick Merrill, president. “Knowing that every child’s life is sacred, it is the promise of Cook Children’s to improve the health of every child in our region through the prevention and treatment of illness, disease and injury,” is the new statement for Cook Children’s to operate by, and one of the system’s focuses this year was aiding the city in giving care to the homeless, especially the more than 1,000 children, he said. Cook Children’s offered health care to those who live in emergency local shelters and is also providing case management services to their families and financial help to enroll in Medicaid.
Cook ChildrenÂ’s will keep its promise into 2009 as it focuses on underserved children in even simple ways, like
continuing to transport children to their appointments through a van service.
To order to serve its child patients, the system has stepped up support of its
staff by increasing benefits and increasing paid time off, Merrill said. The system
will also release its findings from the Community-Wide ChildrenÂ’s Health Assessment and Planning Survey, a
study of the regionÂ’s children and their health care needs, and that will help direct growth for the initial stages
of expansion at the main campus,
which includes more critical care beds and medical office building space. Cook ChildrenÂ’s will also grow in Denton County, where it purchased land for future growth, and building a new primary care clinic in Mansfield.
“Cook Children’s has a solid history of stewardship and planning, which helps in times like these,” Merrill said.
Texas Health Resources
Harris Methodist Fort Worth Hospital, Arlington Memorial Hospital, Harris Methodist H-E-B Hospital, Harris Methodist Southwest Hospital, Harris Methodist Northeast Hospital are all Texas Health Resources hospitals in Tarrant County, and their relation to each other will soon become more evident as THR moves forward with its rebranding campaign, which started in the fall of 2008 and will continue throughout 2009 as an attempt to reiterate the system support and individual histories of the hospitals. Arlington Memorial Hospital had a very noticeable physical change this year as the new Tom Vandergriff Surgical Tower started housing patients, physicians and other health care workers, but all of the hospitals will have changes as signs and names are changed, said Kirk King, president of AMH. Name changes shouldn’t confuse patients, since THR is reaching out to communities to explain name changes, but the hospitals will be united by the system name, family name and community name–for example, the downtown hospital will become Texas Health Harris Methodist Hospital Fort Worth.
The system unification will continue through 2009 and also serves as a reminder to THR’s dedication to providing seamless health care, particularly to those who are underinsured or altogether uninsured who hopefully will be helped by the incoming administration, he said. King said THR is facing many of the same issues hospitals everywhere are–a shortage of nurses, crowded emergency rooms, and physician partners who are struggling to make ends meet in their private practices. The health care system will not be focused on major growth, since much of its growth relies on elective cases that people defer in times of economic hardship, but instead will be working to maintain good services and grow slowly to meet its five-year plans for spending capital. The slow growth will mirror what’s happening in other sectors of the economy, King said.
“We do see an impact on our business, like everyone else does,” he said.
UNT Health Science Center
As Fort WorthÂ’s only medical school, and as a Texas school that graduates many who go on to become primary care physicians, the UNT Health Science Center has been in a period of booming growth since Dr. Scott Ransom joined as president just a few years ago. Numbers alone speak to the impressive expansions happening on the Camp Bowie Boulevard campus: patient visits increased from about 130,000 a few years ago to more than 600,000; the school has a record-setting 1,225 students this year; the number of faculty have doubled; research grants have increased by 30-odd percent for the past two years in a time where research dollars are becoming increasingly difficult to come by. To accommodate all of the changes at the health science center, the campus is also expanding, and a brand-new 112,000-square-foot building is slated to be finished at the end of 2009 and beginning of 2010.
The support for the center and its direction under Ransom are also evident. When he joined the school, only about 200 employees gave back to the institution, and three months into this 2009 fiscal year, more than 1,000 employees have given back some part of their own paychecks to support the academic institution. The 2009-2010 school year is expected to bring more than 1,300 students to the campus, which will become more accessible to its surrounding community and include more green space as it changes over the next several years. On campus, research for AlzheimerÂ’s and aging will be well-supported through research grants in 2009 and the UNT Center for Human Identification continues to work with the Federal Bureau of Investigation and other government agencies, Ransom said. Clinically, the center will be expanding hours for patients to continue an industry-wide trend of making care more accessible.
“The Health Science Center has just sort of been a rocket ship and we’ve just launched into orbit,” he said.
Tarrant County Medical Society
As the representative body for the physicians in the Fort Worth Area, the Tarrant County Medical Society is at the forefront of knowing what sort of issues are facing doctors in this area. One positive thing for physicians that happened this year was the election of Dr. Mark Shelton to the Texas Legislature, said Dr. Melissa Garretson, president of the TCMS. Having a physician in the stateÂ’s House of Representatives will lend some expertise to issues facing physicians and patients, Garretson said, and addressing legislative issues on a state level will be just as important as changes that are expected to come on the national level with a new president. In Fort Worth, the city and the health care community at large have made great strides toward improving health care for the homeless, Garretson said, but physicians are still struggling to balance increasing patient loads with low reimbursements for care.
Next year will see the opening of the new TCMS building in the Medical District, which will replace the current building that is more than 50 years old and near the intersection of Montgomery Street and Camp Bowie Boulevard. The new location will make it more easily accessible for many physicians who work in the downtown area or who drive in on major highways, and it has many environmentally-friendly features that will make it suitable for both physician use and for use by the community, Garretson said. President-elect Dr. Rex Hyer will be taking over Garretson’s position in April, but all physicians will be dealing with whatever impacts come from Obama’s changes to health care. Garretson said she hopes a system-wide change will help get physicians and patients off a “hamster wheel” that just puts off problems instead of solving them.
“Having insurance is one step, but making sure it’s actually a viable, helpful, useful and useable is important for expanding access,” she said.
JPS Health Network
The Tarrant County Medical District went through a noticeable change in 2008 as the JPS Health Network completed and then opened the Patient Care Pavilion, a large tower next to the John Peter Smith Hospital at the south edge of the Fort Worth Medical District. The pavilion marked a renewed focus on accommodating a growing patient population for the county hospital, which is now being lead by Interim CEO Robert Earley after former CEO David Cecero unexpectedly resigned from his position in May.
Despite several attempts to speak to Earley, he did not respond to questions about the health network in 2008 and its plans in 2009. There are some things that are expected to be done in the system for the upcoming year, however. In July, the system was approved to buy the vacant St. Joseph Hospital building at 1401 Main Street for $5.1 million, and although plans have not yet been finalized, this year could lead to a more definite future for the building, which Earley had previously said would most likely need to be completely torn down because it would cost too much to revamp it and bring it up to code. JPS will also probably continue its struggle to find enough space and staff to effectively treat patients at its hospital and its clinics as Tarrant County continues to be affected by a poor economy and more people are without health insurance.
