May 10, 2023
With more than 150 potential projects, the district aims for improved outcomes from a high-functioning safety net system
(Austin) In February 2022, the Central Health Board of Managers adopted the hospital district’s Healthcare Equity Plan, a strategic vision for an equitable, comprehensive, high-functioning safety-net health system for Travis County residents with low income.
Since then, Central Health has focused on the best ways of putting the Equity Plan into practice as a planner, coordinator, funder, and now provider of healthcare within that safety-net system. At its April 26 meeting, Central Health staff and consultants at Guidehouse briefed board members on the progress made so far:
- The team has defined more than 150 initiatives that Central Health could support to achieve the objectives of the Equity Plan. “All of these call for funding and capacity and staff,” Guidehouse’s Dr. Abhi Sharma told the Board of Managers. Central Health has “prioritized what is needed most and can now use its resources most effectively.”
- The team then sorted, analyzed, and prioritized those initiatives into a matrix that will lead to operational roadmaps for healthcare services and demonstrate how initiatives could be combined for efficiency.
- They also distilled 13 initiatives to take to the next phases of planning over the next 60-90 days, in advance of Central Health’s Fiscal Year 2024 Budget and beyond. These initiatives include clinical initiatives and foundational enablers non-medical initiatives that support the Heatlhcare Equity Plan, including more effective care coordination, ensuring health technology systems can exchange and use information effectively, and collaborating with partners focused on improving social determinants of health like housing and transportation.
“Building a high-functioning safety-net healthcare system could cost as much as $500 million over the next ten years, which is why it is important for Central Health to have sufficient reserves to implement the needed improvements.” Central Health President and CEO Mike Geeslin said. “We must get this done. The Healthcare Equity Plan identified a lengthy list of moderate to significant gaps in our healthcare system that have existed for years. They need to be addressed – and we are addressing them. It will take a significant amount of time to get where we need to be, and with the commitment of our employees and partners, we will get to where we need to be.”
The next phases of this effort include an analysis of Central Health’s capabilities and where it needs to invest in personnel, facilities, and support systems to either provide care directly or coordinate care delivered by others. The process also includes financial sustainability planning to ensure services launched in the next several years – with startup capital from Central Health’s approximately $300 million cash reserve – can continue to be funded and/or pay for themselves.
Some of the gaps identified in the Healthcare Equity Plan are already being addressed including increasing specialty care, which Central Health will do this fall when it opens the Rosewood-Zaragoza clinic in East Austin and will continue with 80,000 square feet of planned clinical space at Hancock Center, to be open by 2026.
The board was also briefed on an initiative to connect patients experiencing homelessness to housing and wraparound medical services. Unlike the specialty care initiative, where Central Health is delivering care directly to patients, the homelessness initiative requires coordinating with more than two dozen existing housing and social service providers in Travis County. One near-term possibility is for Central Health to recruit, train, and deploy care coordinators and community health workers at hospital emergency rooms.
“We can put together the best-in-class apparatus to connect people with services other than healthcare,” Geeslin told the board. “But ultimately it will be up to partners. We can take this work to the city and county and can articulate to a much finer degree that this is what will be necessary. Because of our Healthcare Equity Plan, those conversations will be a lot more informed.”