Sunday, March 29, 2009

Tom Green County Indigent Health Care 1998-2006

San Angelo's Health Access Coalition operated from 1999-2003. Increasing access to care for the uninsured was its noble aim. Nearly 30% of area citizens have no health insurance. After years of overspending on Indigent Health and asking the State for supplemental funding, a HAC work group helped Tom Green County spend funds more effectively.
Overspending prior to HAC consultation ($1,252,772)
Changes were made to program coverage that stopped State back filling. The plan covered outpatient surgery, eliminating numerous one night hospital surgical stays. It added payment for nurse practitioners, a less expensive physician extender. Local experts did not charge the county for consultation. The implied deal had the county increasing income qualification to cover more people. County indigent care addresses only the poorest of the poor.
Savings during HAC's existence $1,701,811

The county got an excellence award for the changes showing up in 2001. Some data became available after the coalition ceased operation. Area hospitals chose to end collaboration on the uninsured, due to intense competition for covered patients.
Nationally the number of uninsured grew to 45 million, yet Tom Green County continued to put unspent Indigent Health Care dollars in the general fund. It sat alongside tobacco settlement money.
Savings after HAC's cessation $2,407,237

One question remains. Did qualifying income (percent of federal poverty level) change from 1998-2006? Regardless, Tom Green County netted major funds over a six year period, money previously expended on care for the poor.
Budget Not Spent-Six year total $4,109,048

During this time Tom Green County collaborated with area providers to lever state and federal funds for increased coverage for citizens. That doesn't minimize its backsliding on Indigent Health. TGC spent $5.1 million from 1998-2000. It took six more years to beat that three year total. From 2001-2006 Indigent Health spent $5.6 million. I don't recall the cost of health care going down. The data implies Tom Green County didn't pull its weight.

No comments: