Five leaders at Tarrant County-based hospital systems or hospitals participated in a panel discussion Sept. 25 during the Fort Worth Chamber’s Health Care Symposium at PalmWood in the Frost Tower. Two prominent themes, among others, were preventive care and the questions of care surrounding mental health.

The panel:

Barclay E. Berdan, CEO Texas Health Resources

Robert Earley, President & CEO, JPS Health Network

Rick W. Merrill, President & CEO Cook Children’s Health Care System

Michael D. Sanborn, President, Baylor Scott & White All Saints Medical Center

Jyric Sims, CEO Medical City Fort Worth

Moderator: Marianne Auld, Managing Partner Kelly Hart & Hallman

Presenting Sponsor of the Health Care Symposium was Capital One Bank.

Behavioral Health

Earley describe the mental health continuum of care as a “60-year relation. It’s a lifetime.”

Merrill called behavioral health “a national crisis. We’re all struggling dealing with the stigma and the re-imbursement is pitiful. It’s only going to get worse…with more tragic events…until we get it resolved.”

Earley said JPS sees 15,000 to16,000 mental and behavioral health patients a month. JPS is considering having a mental health care presence in its outreach clinics. “Incarcerating patients is a waste of taxpayer dollars,” he said. “Taxpayers, the system we have is not the right system.” He said there is a link between homelessness, incarceration and mental health, and “I see housing as a partial solution, but not all our patients see it that way.”

Sanborn added that many psychiatrists have gone the private practice route and are not accepting insurance or Medicare.

Preventive Health

The healthcare leaders said they are focused on preventive health to keep patients out of emergency rooms.

Within the THR system, Berdan said social determinants care is the mission. Social determinants could include income and social status, employment and working conditions, education and literacy, access to health services, healthy behaviors, social support, coping skills and more.

“Health status is determined by the choices we make, what we eat, drink, whether we smoke, exercise,” Berdan said. “People choose gratification and assume healthcare will fix it.” He talked about the five-year-old Blue Zones Project. “Join! The Chamber and City and THR have worked diligently to improve the health of our area. We remain committed.”

Earley wants to seriously contain episodic care, which is, “Take a pill, get surgery. Going forward, the effort will be on better preventive care. It HAS to work.” At JPS, the focus will be better nutrition.

Merrill told a story to illustrate thinking outside the box. Cook Children’s researched patients that were hospitalized for asthma three or more times in a year. Cook sent representatives to the home to assess and correct any potential causes. It saw a 75 percent reduction in visits.

Noteworthy shorts:

  • Doctor shortages are prevalent in Texas, especially in small towns and west of Fort Worth. Sanborn and Sims said residency programs at Baylor Scott & White and HCA Medical City eventually could host more than 200 residents a year. “Residents here are likely to graduate and stay here,” Sanborn said.
  • Baylor Scott & White does approximately 600 valve and heart surgeries a year. Many are non-invasive. Sanborn said the hospital’s first live donor transplant could happen around December 1.
  • Berdan said THR is expanding ambulatory care, physician practices, its digital presence and a partnership with UT-Southwestern for clinical innovation.
  • Cook Children’s is expanding, too. It is building a north campus (in Prosper), an urgent care center and breaking ground on a new children’s hospital.
  • Electronic medicine was a topic, including virtual access and patient records. JPS and THR have shared more than six million records this year.
  • Merrill said there are incredible and rapid changes in pharmacology. “It will absolutely change the face of care. The challenge is to fund it. It puts hospitals in a difficult spot (demand vs. cost). It’s a tremendous challenge to address as a nation.”
  • Medicare for all? Sims said Medicare is break-even now. Medicare for all would make the system insolvent by 2023.
  • Berdan cautioned that Texas has more uninsured than any state in the country. Much of their care is in the ER, which is more expensive. “When we release them, we’re not sure they will see a specialist or take their prescriptions,” he said. “So, we keep them in the hospital a couple extra days to watch over them. It’s a big issue for us. (The cost of) uninsured care has to be re-balanced.”
  • Sanborn said the potential for the Medical Innovation District on the Near Southside benefits hospitals, entrepreneurs and companies such as Alcon by bringing to market pharmaceuticals and medical devices. “It’s a collaboration of business, schools and community.”
  • Earley said JPS owns 6.5 acres on S. Main and is considering asking innovative healthcare companies to move here for economic development and medical benefits.