Community Needs and Access to Care

System Growth Driven by Community Need

Baylor has responded to the burgeoning demand for health care in the Dallas/Fort Worth Metroplex with a range of strategic projects designed to respond to market trends over the next century. Between 2000 and 2040, Texas is projected to grow much faster than the rest of the country, increasing its population by more than 70%. Much of that growth will be in North Texas, where the region’s health care system must be prepared.

Baylor has more than $1.6 billion in capital expenditures underway through 2011, including more than $300 million in renovations and improvements. From the expansion of Baylor Regional Medical Center at Grapevine and Baylor University Medical Center to the construction of a new women’s hospital at Baylor All Saints Medical Center at Fort Worth, Baylor is meeting the needs of our rapidly growing region.

Commitment to the Inner-city, Southern Sector

Among the charity care provided by Baylor are dozens of targeted outreach programs with an emphasis on serving those living in the inner-city communities around Baylor, including East, South and West Dallas. In fact, last year the Baylor Senior Health Center at Fair Park treated triple the number of senior citizens that it did during its first year in operation in 2004. The staff at this facility, which is the first new medical facility in this South Dallas corridor in more than 22 years, provides free flu shots at several community events and recently educated patients about the new Medicare Part D prescription drug plan.

The number and quality of these community benefit programs testify to the Baylor mission – to be a Christian ministry of healing that exists to serve all people through exemplary health care, education, research and community service, regardless of a patient’s creed, ethnicity or financial status.

With the goal of serving all people, Baylor recently named a chief health equity officer who is developing and implementing plans to improve equity in health care at Baylor. James Walton, D.O., chief health equity officer for Baylor Health Care System, also is aiming to increase equity in health care access and outcomes within the community.

Baylor University Medical Center, located in East Dallas, is undergoing significant expansion as well as other improvements aimed at easing access to the campus. A Baylor DART station is scheduled to open September 2009, which will create another point of access for residents.

About $70 million in projects are planned for Baylor Dallas in 2006. Over the next three to five years, the campus will see significant enhancements and strategic growth, including a major emergency department expansion; a new circular drive for improved access and convenience; a medical office building, which will house outpatient services and physician offices; an adjacent parking garage; and development of existing space for the Baylor Neuroscience Center, which will expand Baylor’s comprehensive care for neurological and spine conditions.

These tangible projects show the dynamic progress taking place at Baylor’s urban campus through expanded clinical space.

Charity Care Growing

Throughout the system, Baylor annually provides charity medical care to tens of thousands of individuals who cannot pay for their treatment. Baylor consistently exceeds all state legal requirements mandating the provision of community benefit by tax-exempt, not-for-profit health care organizations.

Baylor’s community benefit expenditures in fiscal year 2006 accounted for nearly 21.3% of its net patient revenue, reaching a record $407 million* in unreimbursed costs. The vast majority, or nearly $395 million of the expenditure, went to provide care for charity patients and patients enrolled in government programs such as Medicare and Medicaid. Payments from these federal and state agencies are far below the actual cost of the care delivered.

The remaining $12 million provided for unreimbursed costs of medical education and research, as well as more than 200 community benefit programs. These programs are conducted by Baylor facilities alone or in collaboration with other social service organizations, agencies or churches.

Providing Trauma Care, a Vital Community Service

While Baylor is expanding to meet the needs of a growing community, it has not wavered on its commitment to providing trauma and emergency care. Currently at Baylor Dallas an ambitious $53 million expansion of the medical center's Level I trauma center and emergency department is underway. This expansion will triple the size of the emergency department. Baylor is one of just two adult Level I trauma centers in the Dallas area, and is not supported by tax dollars.

Baylor is strengthening and expanding its trauma center at the same time a troubling new trend has taken hold in health care: fewer hospitals are providing trauma services to their communities. Baylor Dallas continues its commitment to care for the seriously injured in its community. At least 30% of emergency department patients at Baylor are uninsured. Baylor trails only Parkland Health & Hospital System, Dallas County's county-managed, taxpayer-supported facility, in the number of trauma cases handled annually. Children's Medical Center of Dallas is the area's Level I trauma center for children. Parkland and the entire health care system in North Texas will benefit from Baylor's decision to serve more patients in its emergency department.

"There is no greater symbol of Baylor's mission and dedication to the community than our Emergency Department and its Level I trauma program. Serving those with the greatest need at their time of crisis typifies Baylor's dedication to the people of this community."

Dighton C. Packard, M.D. Chairman,
Department of Emergency Medicine, Baylor University Medical Center at Dallas
Member, Baylor University Medical Center Board of Trustees

Increasing Equity, Reducing Emergency Department Use

Among the many programs aimed at increasing equity in our communities is Project Access Dallas, a collaboration between HealthTexas Provider Network physicians and Baylor medical centers, laboratories and radiology facilities, as well as other community partners. A county-wide network of physicians, ancillary providers and hospitals provides a continuum of health care services for the uninsured. With an average monthly enrollment of more than 500 uninsured patients in 2005, Project Access Dallas demonstrated a 35% reduction in emergency department use and a 61% reduction in hospital days for enrollees (an estimated savings of $1,100 per enrollee per year). Baylor has also supported the training of community health workers in chronic disease management for uninsured patients with diabetes who are enrolled in Project Access Dallas. Patients with diabetes receive preventative and acute health care, thus further reducing the need and expense of repeated hospitalizations or emergency department care - the most costly care - for this complex chronic illness.

Providing Innovative Community Programs and Partnerships

Every year, Baylor medical centers respond to the needs in their respective communities through dozens of individually tailored community programs. The programs vary according to the size of the hospital, but all address unmet health needs identified through a community needs assessment.

Baylor medical centers diligently work with local school districts, churches and other not-for-profit organizations in community outreach on major health care issues, and provide a variety of free health screenings, camps, immunization clinics and educational programs. For example, Baylor All Saints Medical Center at Fort Worth provides heart disease and diabetes screenings for African Americans and Hispanics, and Baylor Medical Center at Waxahachie immunizes children and assesses young children for developmental delays free of charge. In addition, through HealthTexas Provider Network, physicians and nurses donate their time and services within their private practices and through several community-based charity clinics.

In addition to its daily community service efforts, Baylor's workforce goes into action during national crises and unfortunate tragedies, such as Hurricane Katrina in 2005. More than 200 physicians on the medical staff at Baylor, as well as clinical workers, volunteered at 24-hour medical clinics throughout Dallas. Some took evacuees into their homes, while Baylor leaders created a fund so all other employees could donate vacation time to help their colleagues cover the costs of hosting evacuees. Baylor donated wheelchairs and offered assistance in job placement at its medical facilities. Baylor employees volunteered at shelters to serve meals and held bake sales to raise money for evacuees.

*The preliminary amount Baylor Health Care System will report to the Texas Department of State Health Services for fiscal year 2006.