cal Home’s $38.5 million budget nearly in half after receiving their budget allo- cations from Parkland. The funds went instead to other hospital projects, Mr. Darrouzet says.
DCMS then withdrew its support for
the Region 9 plan, and Parkland ulti- mately withdrew the project entirely from the plan’s first funding phase. The private hospitals agreed in inter- im talks to restore most of the original funding promised. By then, however, the problem was
more than just money, DCMS President Richard W. Snyder II, MD, says. Over the past year, DCMS was at the
table throughout the planning process — until it came down to final funding decisions. Hospitals also “changed the rules” when they expected physicians to continue caring for large numbers of indigent patients on a charity basis, de- spite what he said were adequate finan- cial resources available under the waiver. Increasing access to preventive care,
improving behavioral health and chronic disease outcomes, and reducing uncom- pensated hospital care like emergency visits are just some of the goals for Re- gion 9, and “physicians are at the heart of all of them. Where does that element play a significant role versus just recoup- ing hospitals’ bottom line?” Dr. Snyder asked.
The waiver’s overarching objectives include things like making sure indigent care funding goes where it is needed most, transforming health care deliv- ery, and enhancing collaboration, he says. “But these themes in their present iteration are failing, and we [physicians] envisioned something much more ambi- tious. This is a missed opportunity to let the physician community as a whole play a greater, more collaborative part- ner, and patients in Dallas are not being effectively served.” Parkland officials declined to com- ment for this story, saying the 1115 waiver is “still a work in progress.” Some public hospitals and governmental enti- ties have argued that because they are putting their funds at risk for unproven innovations so the state can draw fed- eral matching dollars, they earned a say over where those monies go.
February 2013 TEXAS MEDICINE 45
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