CEO Messages

Earlier this month, the Texas Legislature gaveled in its 88th session, and what’s going on at our state Capitol will occupy a great deal of hospitals’ attention for the next four-plus months. If you’re a conscientious health care provider who wants the best possible care environment for your facility, city and state, I’m sure you’ll be following along, too.

As the pandemic tapers off, the need for hospitals has not. With surges of respiratory illnesses inundating emergency departments, hospitals – and hospital workers – remain our most unwavering line of defense.

We’ve all heard about bad things coming in threes. It’s a superstition that has persisted across generations and cultures. Any time three catastrophes happen to fall on top of each other, some point to it as a product of that old adage. There’s no scientific evidence of its validity, of course.

For hospitals and the Texas Hospital Association, once Nov. 8 comes and goes, and the winners of state elections have been declared – including for all 181 seats in the Texas Legislature, as well as for governor and lieutenant governor – an important new phase in determining the future of Texas health care begins.

As health care continues to sit at the front of the public consciousness – as it has since the start of the COVID-19 pandemic – patients and providers alike continue to find themselves characters in a story as persistent as it is frustrating.

With no shortage of polarizing issues circulating in Texas right now, one thing is clear no matter your politics: Mental health is top of mind. The stress of an ongoing pandemic layered with racial tensions, school shootings, divisive abortion laws, and a turbulent economy have pushed behavioral health front and center.

The passage of time takes the sting out of painful memories. It’s a coping mechanism that allows us to move on from trauma and move forward with hope. As the pandemic moves toward second-page news, it’s hard to recall the early days of intense uncertainty, rapid-fire disease spread, school closures, mixed mask messages, travel bans, hand sanitizer rationing, and an abundance of panic as the country embarked on what we thought maybe a few weeks of turbulence and closures.

When the COVID-19 pandemic first took hold of the nation, legislation quickly passed that has allowed most Medicaid enrollees to maintain coverage during the ongoing public health emergency. The federal Families First Coronavirus Response Act granted states an increase in federal Medicaid dollars as long as they paused disenrolling anyone from their Medicaid programs starting in March 2020. With the boost in Medicaid dollars Texas received, the state’s budget was stabilized, and Medicaid enrollees were granted uninterrupted coverage during the PHE.

Health care workers have dealt with endless challenges in recent years, especially after two years of COVID-19 patient care and the resulting burnout and fatigue. As hospitals and health systems face severe staffing shortages, the burden on those workers remaining grows more profound. Amid the mounting pressure and strain, health care workers must contend with, one concern is entirely preventable and must be addressed in a comprehensive and meaningful way. Workplace violence simply cannot be tolerated to any degree within a health care setting. With last month designated as Workplace Violence Awareness Month and June 3 called out by the American Hospital Association as Hospitals Against Violence day, now is the time to highlight what we as organizations and individuals must do to ensure safe, secure work environments for our dedicated health care workforce.

Hospitals around the state are breathing a collective sigh of relief following the Centers for Medicare & Medicaid Services’ approval of three directed payment programs in late March. These vital DPPs raise reimbursement rates closer to the cost of providing care to Medicaid enrollees and amount to $5.3 billion a year in payment enhancements to Texas providers. But for nearly seven months, the programs were left pending as CMS and the State of Texas remained in a deadlock over negotiations regarding the programs’ funding methods — leaving the state’s health care providers wondering if they were rapidly heading toward a financial cliff. The Texas Hospital Association is grateful CMS took a step in the right direction by issuing approval of the DPPs, but we also recognize that more work is needed to ensure the lasting viability of the Texas health care safety net.