Ascension Seton Filed Suit Against Central Health to Protect Equitable Access to Healthcare in Travis County

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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.

Metadata
Provider: 
Business Wire, Inc.Business Wire, Inc.
Retrieved on: 
Wednesday, January 25, 2023
Information
Tags: 
General Health, Hospitals, Health, Professional Services, Legal, Hospital, Dell, Dell Seton Medical Center, University, Central Health, Safety, Catholic Church, Poverty, Patient, Ascension, Dell Medical School, MAP, Seton, University of Texas at Austin, Person, Partnership, Growth, COVID-19, Health insurance, Pharmaceutical industry, Nursing, Central Texas
Geotags: 
UNITED STATES, NORTH AMERICA, CANADA, TEXAS, TRAVIS COUNTY
Organisation: 
ASCENSION
Summary
Key Points: 
  • 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 maintains that Central Health has misrepresented its agreement and used distorted numbers to inaccurately represent growth of the MAP program.
  • Ascension Seton also maintains that 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.


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. Ascension Seton believes that 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.

Ascension Seton maintains that Central Health has misrepresented its agreement 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. Ascension Seton also maintains that 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 70% 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.

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