Two years ago while blow-drying her hair, Candace Young felt a shooting pain down her right arm. After a gentle pleading by her husband, Young agreed to check into Methodist Richardson Medical Center.
Young had suffered a blockage to her coronary artery that called for triple bypass surgery. She said she felt lucky her home in Murphy was just a 10-minute drive from the hospital, where she received care for 10 days.
Methodist Richardson Medical Center is gearing up to provide more patients like Young with the care they need.
In December, the hospital will open the first 50 beds associated with its $85 million, two-story expansion, a project that kicked off in 2017.
Hospital President Kenneth Hutchenrider has said the expansion was prompted by “explosive growth” in and around Richardson.
“We see a tremendous amount of economic boom all around us, so we want to position ourselves to be able to care for that continued growth,” he said.
Data provided by Methodist Richardson shows that in 2016, 1.1 million people lived within the hospital’s service area. By 2021, that number is projected to increase by 7%.
Population growth not just in the DFW area but also statewide is placing a “tremendous strain” on the state’s health care system, especially as the number of uninsured residents grows, said Dr. Douglas Curran, president of the Texas Medical Association.
And while facility expansions are necessary in some cases, Curran said the perception of hospitals as the go-to facility for care is indicative of a larger issue—one that is driving up the cost of health care for all Texans, not just those who are sick.
“Our hospitals have too many beds in general,” Curran said. “We want to be able to treat people on an outpatient basis—keep them out of hospitals and keep them healthy because then they are productive citizens.”
A BROKEN CRYSTAL BALL
In 2012, hospital officials anticipated Methodist Richardson would discharge 4,840 patients in fiscal year 2018-2019. As of March 31, six months into its fiscal year, discharges from the hospital totaled 8,373. By fiscal year’s end, the hospital is projecting 12,997 discharges—over 2 1/2 times the number anticipated in 2012, according to Methodist Richardson.
Between 2017 and 2018 alone, the hospital saw a 15 percent increase in patient days, or the total number of days each patient spends in the hospital.
Partly responsible for the patient uptick is the closure of Baylor Scott & White Medical Center-Garland in 2017, Hutchenrider said. Prior to that, Methodist Richardson averaged about five ambulance runs per day from Garland Emergency Medical Services. Today, that average has increased fivefold.
This, along with regional population and development growth, prompted Hutchenrider to fast-track plans for the hospital expansion.
“We were already planning the expansion, but this made us pull the trigger even faster,” he said. “... It was the perfect storm.”
The project has been met with a warm welcome from the city, which views the expansion as a major economic turning point for the region.
“This expansion shows that we are a strong market for a really advanced health care provider, and I think that from a business community perspective we can take comfort that we have a really Tier 1 provider in the community,” Richardson Chamber of Commerce President Bill Sproull said.
The first slew of bed openings in December will create 90 jobs, ranging from nurses to lab technicians, and add $5 million to Methodist Richardson’s payroll, according to hospital officials.
The expansion entailed adding two more floors, each comprising 75 patient rooms. Also included in the project was a ninth operating room, seven pre-operating rooms, a third cardiac catheterization lab and a parking garage.
At first, only the sixth floor will be equipped and staffed, Hutchenrider said. The fifth floor will remain empty until the demand for more beds is there. When that will happen is unclear, but Hutchenrider said having the floor built will help speed up the process.
“We weren’t even supposed to be doing this [expansion] until 2024, so my crystal ball is broken,” he said.
DEMOGRAPHICS DRIVE BUSINESS
CityLine’s opening in 2014 was a major milestone in Methodist Richardson’s growth, Hutchenrider said.
This, along with other corporate move-ins, increased the number of high-income, well-insured residents living within the hospital’s service area, something Hutchenrider said he was keenly aware of when contemplating the viability of a multimillion-dollar expansion.
“Most definitely we take [demographics] into consideration,” he said. “We have plentiful jobs here in the Richardson area. … They’re all upper blue- to white-collar.”
The percentage of insured residents living within Methodist Richardson’s service cities ranges from 77%-92%, according to the U.S. Census Bureau’s Five-Year American Community Survey. The median annual household income among those same residents falls roughly between $77,000 and $129,000.
Still, patients at Methodist Richardson originate from areas across the Metroplex and even statewide, and a good number are either totally uninsured or covered by government-subsidized programs, such as Medicaid or Medicare.
In 2018, 22% of patients seen at Methodist Richardson were insured through Medicaid, Medicare or a combination or both, and nearly 14% of patients had no insurance at all.
By 2023, the hospital expects the percentage of patients with Medicaid to increase by 2%, patients with Medicare to increase by 25%, and patients with a combination of both to increase by 20%.
Because reimbursement by the state and federal government for treatment of patients with Medicare or Medicaid is extremely low, finding primary care doctors willing to accept these plans can be very difficult, Curran said.
As a result, when patients with these plans get sick, they often go to hospital emergency rooms—the one place they know they will not be turned away. The same applies for uninsured residents.
“The huge uninsured population is really costing our state, and it affects our quality outcomes,” Curran said.
When uninsured people are treated in a hospital, health care premiums increase across the board, Curran said. That is why the Texas Medical Association has pleaded with state legislators to use every federal dollar possible to fund innovative, affordable patient care solutions, he said.
“This would help all of our facilities have more resources, and it would empower independent physicians and physicians collaborating with hospitals to really take care of the patients in the right setting rather than in a real high-cost area,” he said.
Still, as the medical community awaits a better solution, Hutchenrider said adding hospital beds is one way to address the high demand for care.
“To try and figure out [keeping health care affordable] is an astronomical task,” he said. “But I do believe everyone has to have health care coverage that is routine and sustainable.”