The Truth Behind Central Health’s Attempt to Gain Control of Dell Seton Medical Center

Ascension Seton has proudly provided critical healthcare services for Travis County’s most vulnerable residents for 120 years as part of our mission to provide compassionate care for all and support the communities we serve.

Now Central Health wants to own and operate Ascension’s Dell Seton Medical Center at The University of Texas, despite having no experience or capability to run a hospital and the only Level 1 trauma center in the region. This would create an inequitable, two-tier healthcare system that would disadvantage the county’s most vulnerable residents and place new burdens on county taxpayers.

The risks for Travis County residents if Central Health takes over Dell Seton Medical Center:

• Unnecessary costs
• Higher taxes
• An inequitable two-tier healthcare system

History of MAP

Over the past three decades, Ascension Seton have partnered with local government agencies — most recently, Central Health — to build a unique public-private collaboration for the availability of the Medical Access Program (MAP). Through the MAP program and our agreements with Central Health, Ascension Seton has effectively and efficiently served as a healthcare provider for the most economically vulnerable residents of Travis County. These services are part of a “safety net” system to help ensure disadvantaged populations receive vital healthcare regardless of insurance status and ability to pay. Over time, our collaboration has saved and improved thousands of lives by providing equitable access to healthcare throughout the community.

The benefits and cost-effectiveness of this unique public-private collaboration have been proven:

• Our collaboration brings efficiencies to care delivery and avoids duplication of many services by leveraging Ascension Seton’s existing facilities and clinicians;
• We have leveraged available state and federal resources to cover some of the cost to increase funding for healthcare services to vulnerable community members;
• Travis County’s uninsured and financially disadvantaged residents receive quality, equitable care; and
• Travis County taxpayers pay the lowest tax rate of the six major safety net hospital districts in Texas.

Central Health Has Over-Enrolled and Underfunded MAP

For more than five years, Central Health has disregarded the terms of our arrangement for the MAP agreement and increased the number of individuals enrolled in the program to far exceed what it was designed and funded to support. Central Health has unilaterally over-enrolled participants in the program, while refusing to provide funding to support care for these additional patients. During this time, Ascension has stepped up and continued to provide that necessary care for this increased population of patients at a cost to Ascension Seton of tens of millions of dollars.

Proper funding for MAP is readily available today. Central Health’s reserves have multiplied tenfold over the past five years — currently sitting at well more than $400 million. These taxpayer dollars are supposed to support healthcare programs, like MAP, and benefit Travis County residents.

Central Health’s Not-so-Hidden Agenda

While we have been negotiating in good faith for several years to find an amicable solution for expansion of services and funding, it is clear that Central Health was making other plans. During this negotiation period, Central Health budgeted more than $100 million for healthcare services it did not purchase or provide. Instead of expanding services for Travis County residents, Central Health used those unspent healthcare funds to grow its reserves to nearly $400 million. The public entity is also incurring significant new administrative expenses, such as a new headquarters facility, which will come at a reported initial cost of $63 million to taxpayers.

Despite its massive reserves, Central Health continued to impose annual tax increases on Travis County property owners. Central Health’s taxes are lower than other major healthcare districts in Texas, but that will not remain the case if Central Health owns and operates a hospital. Healthcare districts in other Texas metropolitan areas that operate their own hospitals have tax rates that are double the current Central Health rate.

Why would Central Health want to own and operate a complex acute-care hospital, at taxpayer expense, and without any demonstrated ability to do so? Why would it want to be more like other, high-tax-rate hospital districts across Texas? Central Health owes the residents of Travis County sensible answers to these questions.

Through Central Health’s unelected Board of Managers, taxpayers would bear the financial risks and fluctuations of operating a standalone public hospital without the necessary expertise and infrastructure.

For more than five years, Ascension Seton has engaged in negotiation and mediation to attempt to resolve Central Health’s breaches of the terms of our agreements. Unfortunately, those efforts were not successful and Ascension has now asked a court to intervene in this matter. Ascension is asking the courts to direct Central Health to fulfill its obligation to pay the costs associated with the care provided to the residents of Travis County.

Future of Collaboration to Serve Travis County’s Most Vulnerable

Ascension Seton has continued to provide equitable care for all MAP patients for the past several years despite Central Health’s failures to properly manage MAP enrollment, and it will continue to support MAP patients as the legal process proceeds.

We anticipate the legal process will result in Central Health once again meeting our shared commitment to serving Travis County’s most vulnerable. With legitimate cooperation and a sound strategy, there is much we could accomplish together by leveraging Ascension Seton’s existing healthcare delivery system and Central Health’s intended role as the funder of healthcare services. This is why we question the need for Central Health to maintain such large reserves of taxpayer dollars when critical healthcare programs remain underfunded.

On May 2, 2023, Ascension Seton sent Central Health a notice of governance and funding deadlock in an effort to get Central Health back to the table to work collaboratively.

Central Health needs to do its part to help ensure proper funding for the MAP program moving forward and clearly and transparently align its operations and finances with the critical healthcare programs upon which it was founded.