This page shows the COVID-19 capacity of hospitals in Wise, Ellis, Dallas, Parker, Denton, Johnson, and Tarrant counties. However, patients don't share the good times. Of the 20 most populous counties in the country, none has a higher concentration of medical debt than Tarrant County, where Fort Worth is located. The second is Dallas County, credit agency data show.
The uneven fortunes of hospitals and their patients go far beyond this corner of Texas. Across the country, many hospitals have grown rich and are spending lavishly on advertising, team sponsorships, and even spas, while patients are pressured by skyrocketing medical prices and rising deductibles. A KHN review of hospital finances in the country's 306 hospital markets revealed that several of the most profitable markets also have some of the highest levels of patient debt. Many are persecuted by collectors when they can't pay their bills or hospitals sell the debt.
Across the Dallas-Fort Worth metropolitan area, the fourth largest in the country, the impact has been devastating. Overall, in Tarrant County, 27% of residents with credit reports have medical debts on their records, data from credit agencies analyzed by KHN and the nonprofit Urban Institute show. Last year, Zipprich returned to work and accepted a job in New Jersey that required traveling to and from Texas. He recently stopped smoking, citing the stress of traveling so much.
“I never thought this would happen to me,” he said. Hospital industry leaders blame health insurers for patients' debt, citing the rise of high-deductible plans and other initiatives that limit coverage. “The last thing hospitals want is for their patients to face financial barriers,” said Molly Smith, who directs public policy for the American Hospital Association. Hospitals are there trying to work on behalf of patients.
Despite repeated requests from KHN, none of the Dallas-Fort Worth medical systems wanted to talk about their finances or patients' debts. However, Smith and other hospital leaders point out that hospitals across the country provide billions of dollars in free or discounted care each year. “The hospitals have been very generous,” said Stephen Love, president of the Dallas-Fort Worth Hospital Council. If other parts of the community did as much as hospitals, we wouldn't be in this problem.
Unlike pharmaceutical companies, device manufacturers, and many doctors' offices, most of the U. S. Hospitals are not for profit and must provide charitable care as a condition of their tax-exempt status. Regardless of the fiscal situation, medical centers in markets with high medical debt offer more charitable care, according to an analysis by KHN and the Urban Institute, a Washington-based think tank.
Vikas Saini, president of the Lown Institute, a non-profit organization that rates hospitals based on their quality and community benefits. Around Dallas-Fort Worth, major medical systems often trumpet their commitment to the region and their patients. The big wave of buildings has been accompanied by great benefits. Other major systems in the area, such as Baylor, Children's Health and HCA, the largest for-profit hospital company in the country, performed better according to KHN.
Cook Children's, the second largest pediatric system in the region had an average operating margin of nearly 12%. Hospitals have thrived in other markets with high patient debt says KHN. The average margin at hospitals in and around Gainesville and Lakeland two central Florida markets where a quarter of residents also have medical debts was over 9%. In Tulsa Oklahoma In fact according to the analysis there is no apparent relationship between the profits of hospitals in a market and the amount of medical debt that residents have.
So while hospitals in places like Charlotte and Tulsa may be comfortably in black numbers in other places with high patient debt such as Amarillo (Texas) and Columbia South Carolina Industry experts say that the most profitable medical centers such as those surrounding Dallas-Fort Worth have developed business models that allow them to thrive even if their patients can't afford to pay. These hospitals maximize what they charge for everything from complex surgery to a dose of aspirin. Most of these charges are paid by health insurers which continue to pay a much larger share of hospital bills than patients even those with the highest deductibles. Across the country many medical systems have strengthened their market power in recent years by consolidating and buying smaller hospitals and doctors' offices allowing hospital systems to charge even more.
In addition to charging more more profitable hospitals tend to get more savings from their operations for example by withholding what they pay workers and getting better contracts with suppliers. Hospitals have had to be thinner and more petty said Kevin Holloran senior director of Fitch Ratings which tracks nonprofit health systems for the bond rating firm It's unclear how much longer this business model can last. Across the country many small and rural hospitals have closed in recent years Even some larger systems are now losing money as inflation and rising labor costs put new pressure on outcomes Robert Earley a former Texas state legislature who ran the Fort Worth public health system compared current hospitals to shrimp farmers in the Gulf Coast district he once represented KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health topics. It is an editorially independent operating program from KFF (Kaiser Family Foundation).
With a population of 2 million Tarrant County is the third largest county in Texas in terms of population Dallas-Fort Worth has the highest medical prices in Texas according to the Health Care Cost Institute a nonprofit organization that tracks costs across the country As the only Level I trauma center in Tarrant County John Peter Smith Hospital in Fort Worth sees nearly 4 000 trauma patients a year. The American College of Surgeons estimates that a level I trauma center -the highest designation a hospital can receive- is needed for every million people meaning that Tarrant County needs at least two level I hospitals In August or September The Baylor Scott & White Medical Center opened its new $1 billion facility near downtown Fort Worth The new facility will include an emergency department with more than 100 beds an intensive care unit with more than 50 beds an operating room with more than 30 beds an imaging center with more than 20 beds an outpatient clinic with more than 10 beds and a cancer center with more than five beds The new facility will also include an advanced trauma center which will be able to treat serious injuries such as gunshot wounds car accidents or falls from heights It will also include an advanced cardiac care unit which will be able to treat heart attacks strokes or other cardiac emergencies The new facility will also include an advanced neonatal intensive care unit which will be able to treat premature babies or babies born with serious birth defects The new facility will also include an advanced burn unit which will be able to treat serious burns or skin conditions It will also include an advanced orthopedic unit which will be able to treat broken bones or joint injuries The new facility will also include an advanced neurosurgery unit which will be able to treat brain injuries or spinal cord injuries The new facility will also include an advanced transplant unit which will be able to perform organ transplants such as kidney liver or heart transplants It will also include an advanced cancer center which will be able to treat various types of cancer such as breast cancer lung cancer or prostate cancer The new facility will also include an advanced rehabilitation center which will be able to help patients recover from serious injuries or illnesses It will also include an advanced mental health center which will be able to help patients cope with mental health issues such as depression anxiety or post traumatic stress disorder The new facility will also include an advanced research center which will be able to conduct research into various diseases treatments or cures It will also include an advanced education center which will be able to provide educational programs for healthcare professionals students or members of the public The new facility is expected to increase access to healthcare services for residents of Tarrant County It is expected that it will increase access not only for those who live within Tarrant County but also for those who live outside Tarrant County but need access to specialized healthcare services The new facility is expected to increase access not only for those who need specialized healthcare services but also for those who need access to general healthcare services such as primary care preventive care or chronic disease management.