Wednesday, December 5, 2012

Dallas County Medical Society to Cease Operations of Project Access Dallas in 2013

By Jim Walton, DO, Medical Director, Project Access Dallas, and
Richard W. Snyder II, MD, President, Dallas County Medical Society

Dr. Walton
The Dallas County Medical Society has made the difficult decision to cease operations of Project Access Dallas, a program created by DCMS physician leaders in 2002. The nationally recognized service project provided over $34 million in charity care to the uninsured and grew to include more than 2,000 physician volunteers serving over 10,000 uninsured patients during its 10-year span. The unique components of Project Access Dallas included its creative partnerships with area charity clinics, hospitals, pharmaceutical benefits managers, and other healthcare organizations. The decision to close the project over the next 3 to 6 months is a result of the difficulties encountered during the planning of the project’s transition to funding through the state of Texas’ “1115 Medicaid Waiver.”

Dr. Snyder
Under the new 1115 Medicaid Waiver, Dallas’ area hospitals will receive increased federal tax dollars totaling over $4 billion in Dallas, Denton, and Kaufman counties over the next 4-year period. Despite DCMS efforts to influence the decisions, we were informed that local hospital systems had unilaterally created plans for these funds to compensate hospitals using over 95 percent of the available funds, leaving the balance for private physicians and charitable clinics. This action disregarded the 1115 Waiver’s primary intent to transform and improve access to primary and specialty physician care. Without a more just, collaborative, and transparent process to negotiate delegation of these resources, local physicians and charitable clinics are unable to meaningfully participate in this important project for our area.

The imbalance and unfairness of these health care funding decisions minimizes the critical role of physicians and charitable clinics in reducing uncompensated hospital care. This impasse reached a breaking point on November 7 when the private hospitals informed DCMS that they had reduced the planned budget for Project Access by almost 50 percent. As a result, DCMS submitted a letter on November 15 to the Texas Department of Health and Human Services withdrawing its support for what is known as the Region 9: 1115 Waiver Regional Health Plan, making it necessary to disband Project Access Dallas. It is regrettable that DCMS has been forced to make this unfortunate decision.

Over the next 3-6 months Project Access Dallas staff will work to transition its current 3,000 patients into new medical homes and help them find new sources of medication as needed. Enrollment and re-enrollments of patients will cease immediately. DCMS leaders will begin working directly with state and federal officials, and elected leaders to transform healthcare delivery in Texas consistent with government’s triple aim to improve the experience of care, improve the health of populations, and reduce the cost of health care without compromising quality.

The Dallas County Medical Society unites and empowers physicians to support the health of all residents in the metropolitan region. DCMS is a professional organization of approximately 6,400 local physicians, medical students and residents dedicated to serving Dallas area patients.


Anonymous said...

I am reading a book titled "Decoding the Obama Health Plan" by Betsy McCaughey, PhD who says that the majority of the "uninsureds" will go into Medicaid. If every person in the US is insured, there would no longer be any need for charity medical care.

When I went into practice with Claude Winborn, M.D. in 1868 he had said when Medicare went into effect in 1965-66 "we will get paid for what we have been doing for nothing."

History repeats itself, for a while at least!

Anonymous said...

The Hospitals will have to answer to a higher power, and I don't mean their Boards of Dirctors.

HA ParnessMD

Anonymous said...

It is incredible how much power hospitals have. When will we as health care providers band together, the way hospitals do, in order to advocate for our patients? I thought those monies were to improve access to care. It is well documented that care is not delivered in hospitals but rather in the community by health care providers. Hospitals are needed when medical car fails to get the results needed. Hence, monies should be given to physicians, in particular, primary care physicians. We need prevention and chronic disease management and not hospital care. Our elected officials need to understand this. So when will we band together as health care providers?......
Alice Masciarelli, RN, MSN, FACHE, CPHQ

Anonymous said...

there are always going to be uninsured. for example, undocumented or recent immigrants. also people in the margins who can't keep it together enough to sign up for a health plan. or transients. volunteering in charity clinics to help these types of people has been a rewarding experience for me for 9 yrs, most recently in PAD. PAD was for some of us a mechanism to simply do some pro bono service for the neediest. No ulterior motive. Is a shame to dismantle this infrastructure over the issue of leverage for getting some of the dollars redistributed from hospitals to doctors. and the weakest are always the ones suffer most from these sorts of decisions.

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