News

Dear Editor,

On Sept. 11, The Austin Chronicle published the story “Central Health Budget Suggests Waning Trust in Ascension.” Ascension Seton was not contacted for comment or input on the story. Had The Austin Chronicle reached out, here’s what readers would have learned about this complex issue.

• Seton has seen every MAP patient that Central Health has referred to us, in good faith, even though Central Health enrolled thousands more participants than our agreements allowed. Despite Central Health’s claims to the contrary, the goal was never to have the same number of hospital visits as in 2013. The goal was and remains to see patients in appropriate settings and, through case management, reduce the hospital visits for the 25,000 MAP enrollees.
• Central Health was intended to be – and initially was — a material part of the public funding for hospital services for the safety net, but recently stopped providing funding and since 2020 has provided less than $1 million per year for these hospital services.
• By unilaterally increasing the number of patients participating in the MAP program and not paying for the additional participants, per the agreements, Central Health has left Seton with tens of millions of dollars in additional costs.
• Seton receives only partial funding from state and federal programs for services delivered to the safety net population, generally covering less than half of the cost of the services. To meet the expanded need, we depend on the strength of our system, our donors who are committed to caring for those most in need AND governmental entities (Central Health) meeting their financial and contractual commitments.
• Year after year, Central Health has budgeted tens of millions of dollars to expand health care services for the safety net patients, and knowingly failed to spend those dollars for Travis County residents, preferring to set it aside for a future, unclear plan. Mayor Watson recently said, “…right now there are significant needs, and parts of that distant plan align directly with those immediate needs and the missions of both Central Health and Integral Care.”
• Seton has provided $5.6 billion in uncompensated care and community benefit in Central Texas over the last 10 years, as reported to the Texas Department of State Health Services.
• Seton has been part of Austin since 1902 and it was and is our mission to care for those most in need. Through our infrastructure, MAP patients currently have access to 15 high-quality hospitals and 250 clinics across Central Texas. Central Health’s plan would return to a fragmented, two-tier system that’s not equitable, and that costs taxpayers significantly more. The residents of Austin and Travis County deserve to hear the full story.

For 120 years, Ascension Seton has proudly provided critical healthcare services for Travis County’s most economically vulnerable residents.

As part of this mission, we’ve worked with Central Health since 2004 to build a unique public-private collaboration to care for the uninsured, while effectively and efficiently using taxpayer money, and strengthening the local county indigent care program. Through the Medical Access Program (MAP), we have provided equitable access to healthcare throughout the community while also helping maintain the lowest tax rate of the six largest safety net hospital districts in the state.

For more than five years, Central Health has disregarded the terms of the agreement and increased the number of individuals the program was designed and funded to support. During this time, Ascension has also stepped up to provide that necessary care, without Central Health compensating Ascension according to the agreement. Meanwhile, Central Health’s contingency reserves have multiplied tenfold in the past five years, currently sitting at more than $400 million — even as there are unmet needs of the population Central Health was created to serve.

After Central Health summarily withdrew from negotiations, on Jan. 24, 2023, Ascension Seton asked a court to intervene and direct Central Health to fulfill its obligation to pay the costs associated with the care provided to the residents of Travis County.

On May 2, 2023, Ascension Seton sent Central Health a notice of governance and funding deadlock with respect to the Community Care Collaborative (CCC). The CCC was formed by Seton and Central Health “to coordinate all available health care resources and implement an IDS [integrated delivery system].” Instead of coordinating care through the CCC, Central Health has attempted to operate outside of the jointly owned entity. The deadlock notice is an effort under the parties’ contracts to get Central Health back to the table to work collaboratively in a way that will better meet current and future needs of Travis County.

It is our hope that new agreements can be reached with Central Health and that our public-private collaboration can continue, for the sake of both MAP patients and the taxpayers of Travis County. Visit CaringForTravisCounty.org to learn more about this important issue.

Lawsuit Seeks Court Intervention to Order Central Health to Fulfill Its Obligations to Support Medical Access Program for County’s Most Vulnerable Residents

Austin – Ascension Seton today announced it filed a lawsuit against Central Health. This action seeks to address Central Health’s over-enrollment and underfunding of the Medical Access Program (MAP), the county indigent healthcare program and the public-private partnership designed to provide equitable access to care for Travis County’s economically vulnerable residents.

Ascension Seton had been seeking a good faith resolution to Central Health’s continued refusal to support increased demand for MAP services but was forced to seek legal remedy after Central Health refused to engage in further good faith discussions and negotiations. Central Health’s taxpayer-funded lawsuit is focusing on the wrong numbers. The data clearly demonstrates the success of the MAP program — through improved clinical outcomes and a better continuum of care. Central Health repeatedly cites a 10-year-old agreement in their lawsuit, but completely ignores 23 agreements they have ratified since then that detail baseline numbers for appointments in specialty care.

Central Health has misrepresented its agreement with Ascension Seton and used distorted numbers to inaccurately represent growth of the MAP program. For more than five years, and as the Travis County population continues to grow, demand for MAP services has far exceeded the number of individuals the program was designed and funded to support. Central Health has unilaterally overenrolled individuals into the healthcare program while refusing to provide funding to support the care for these additional patients. After years of attempted negotiation and mediation, Ascension Seton has no choice other than to seek a legal remedy.

“Despite Central Health’s ongoing refusal to support increasing demand for MAP services and disregard of the existing contract regarding MAP membership, Ascension Seton has worked in good faith to continue providing critical healthcare services to Travis County residents,” said Andy Davis, President and CEO, Ascension Texas. “Even with today’s developments, we will continue to focus first on caring for patients, aligned with our mission to provide quality care to all. It is unfortunate that Central Health through its inappropriate actions has forced us to take this legal action to ensure that Central Health meets its commitments to the community it was created to serve.”

MAP is the healthcare program for economically vulnerable residents in Travis County and is part of the “safety net” system. Over the years, its distinctive approach has benefited residents, saving and improving thousands of lives by providing equitable access to healthcare throughout the community, while also maintaining the lowest tax rate of the six largest safety net hospital districts in the state.

As demand for MAP services continued to grow in recent years, however, Central Health continued to enroll more and more people into the program while refusing to adjust its reimbursement to Ascension Seton for such services accordingly. This approach is not dictated by lack of funds.

Central Health’s contingency reserves have multiplied eightfold in the past five years, currently sitting at more than $300 million — even as there are unmet needs in the population the agency was created to serve. The public entity is also incurring significant new administrative expenses, such as a new headquarters facility, which will come at a reported cost of $63 million.

“We question the need for maintaining such large reserves of taxpayer dollars when the critical healthcare programs those dollars are intended for remain underfunded,” said Davis. “We are disappointed to see that Central Health is attempting to distort the facts surrounding demand for MAP services and the nature of our agreement. We are confident that the legal process will result in a solution that provides adequate funding for the MAP program moving forward.”

Ascension Seton has continued to provide equitable care for all MAP patients for the past several years despite Central Health’s financial shortfall, and it will continue to support MAP patients as the legal process proceeds. Ascension will also continue to build on its strong legacy of giving back to the community.

Over the past 10 years, Ascension Texas has provided on average $549 million in charity care and community benefit in Central Texas, as reported to the State of Texas. These efforts continued even as Ascension and the community navigated the unique challenges of COVID-19. At Dell Seton Medical Center at The University of Texas, nearly 40-45% of patients served by Ascension are uninsured or under-insured. Across the organization, Ascension provided more than $2.4 billion in FY22 for care of persons living in poverty and other community benefits.

“It’s time for Central Health to clearly and transparently align its operations and finances with the critical healthcare programs upon which it was founded,” said Davis. “We are committed to our mission of over 120 years that calls us to serve all residents of Travis County.”

About Ascension Texas
In Texas, Ascension operates Ascension Providence in Waco and Ascension Seton, which includes Dell Children’s Medical Center, the region’s only comprehensive children’s hospital and pediatric Level I trauma center, and Dell Seton Medical Center at The University of Texas, the region’s only Level I trauma center for adults. Ascension Seton partners with Dell Medical School at The University of Texas at Austin and shares a common vision of transforming healthcare through a focus on quality and value. Serving Texas for more than 120 years, Ascension is a faith-based healthcare organization committed to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. Ascension is one of the leading non-profit and Catholic health systems in the U.S., operating 2,600 sites of care – including 139 hospitals and more than 40 senior living facilities – in 19 states and the District of Columbia. Visit www.ascension.org and www.dellchildrens.net.