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Review points the way for Central Health improvements

Wednesday, February 21, 2018 by Chad Swiatecki

A recent study of Central Health’s services and performance for the Austin area has recommended that the agency take further steps to improve health care access for all residents – especially marginalized communities – as well as toward improving its outreach and messaging around its purpose, and stepping up its efforts to secure federal grants and philanthropic donations.

The study, which cost $350,000 and included a separate forthcoming analysis of Central Health’s insurance plans, was performed by Ohio-based Germane Solutions and compared Central Health to similar agencies in major Texas metro areas and 10 cities across the country. Central Health leadership commissioned the study just after the spring 2017 hiring of new CEO Mike Geeslin, with much of the data gathering and interviews conducted late last year.

The Central Health performance review found that the agency has less control over care delivery and other external factors because it does not operate its own hospital system, unlike most similar area health care delivery systems. Instead, affiliated groups such as Seton Healthcare Family and St. David’s HealthCare operate alongside Central Health, which creates issues with accountability, transparency and the community’s understanding of the role the agency plays in coordinating use of health care resources and delivery throughout the Austin area.

Along with suggesting the agency look at diversifying the funding sources for its $237 million budget, the report also says an issue exists in having enough providers in areas of specialty care throughout the area.

Tracy Kulik, vice president of health access for Germane Solutions, said Central Health faces a changing landscape when it comes to serving threatened populations such as the homeless and needs to work on addressing the “fuzziness” that exists in the public perception of what it does.

“There needs to be better branding because there’s no statement that says, ‘This is who we are,’ which is difficult when they most identify as a kind of holding company that provides resources to the area’s service providers,” Kulik said. “In terms of access they are superior and the gold standard, but that is coming under scrutiny because of geographic issues because the downtown low-income and homeless populations are moving out into other areas. There are questions about what needs to be done to continue to serve those people.”

The document doesn’t directly address the controversy that has followed Central Health and the Dell Medical School at the University of Texas in recent years, with critics charging that those bodies, as well as Seton, have misallocated or misused general obligation bond money raised from a 2012 tax increase to pay for community care. The only statement that could be interpreted as related to that controversy is a finding that “Central Health does not have full influence and visibility into how funds flows to partner entities are ultimately used to benefit the community.”

Geeslin said he and other Central Health leaders are already at work addressing some of the report’s findings. The agency also provided its own official response to the review.

“Some pieces, like increasing access and improving the availability of specialty care through Seton and the Community Care Collaborative, we’re already working on those by expanding the types of specialty care, adding more contracts in those areas and looking at better ways to connect primary and specialty care providers,” Geeslin said. “There are different stages with something like this and you have to get started to get an idea of what the new answers will be. There are areas in the public/private models where we know we have some trade-offs, but to have strong partnerships and deliver strong outcomes – that can mean you have to relinquish some control.”

With regard to Central Health’s fundraising and revenue practices, Geeslin said any change toward more grants and donations would take time to implement.

“That’s one I will need to deliberate on but this gives us the extra push to improve our financial strength,” he said. “When you look at the past few years and the efforts to draw down on additional federal funds, that’s been a unique way we’ve been able to provide health care for Travis County.”

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