Publications

Texas Local Indigent Health Care Report

A 2007 report from Morningside Research and Consulting summarizes the indigent health care programs operating in all 254 counties in Texas.

The report contains never-before-compiled information about Texas' program for providing health care to residents living well below the federal poverty level.

This report and companion data file are essential for policy makers and program administers who need to know who this program serves and how it is funded.

The summary report aggregates the data provided by the 300 local programs responsible for indigent health care in Texas and contains information on the following:

The data file, in Microsoft Excel, contains detailed information about each of the 300 programs in Texas with statutory responsibility for indigent health care. The following is a sample of the extensive information available for each program:

Texas Hospital District Comparison Reports

Morningside Research and Consulting publishes a series of four comprehensive reports annually designed to help administrators of public hospitals, organizations working with public hospitals, and public policy researchers benchmark the financial and operating performance of public hospitals.

The four reports are based on the most recent financial statements and budgets available and other sources from the 10 largest hospital districts in Texas. These reports contain the most current and comprehensive source of information on public hospitals in Texas.

The easy-to-read reports provide a way to compare the significant differences among the 10 largest hospital districts in Texas.

These comprehensive reports serve as a benchmarking guide for public hospitals. Public hospitals, hospital districts, hospital systems, commissioners courts, other elected officials, and organizations that work with public hospitals such as accounting firms, law firms, and consulting firms will benefit from the information in these reports.

The four hospital district comparison reports will be published in 2007 and will be released on the following dates:

• Financial report - March 30, 2007
• Mental health report - June 29, 2007
• Primary care/indigent care report - September 28, 2007
• Inmate health report - December 31, 2007

1. Financial and Operating Statistics Comparison Report

   

   Put the financial performance of your public hospital in perspective. This comprehensive report contains the financial benchmarking data needed to justify the expenditure of public funds and to satisfy questions from elected and appointed officials about comparative performance.

   Hospitals and firms that work with public hospitals now have the data to compare public hospital performance. The report is designed to easily compare any public hospital to other hospitals having similar missions and roles in their communities.

   The unbiased and independent information in this report, based on the most recent financial statements, budgets and other sources, provides benchmarks for:

   • Budgeted and actual revenue and expenditures
   • Tax rates and revenue
   • Payor mix
   • Financial position
   • Operating statistics

2. Mental Health Care Comparison Report



Although Texas ranks 6th nationally in total mental health spending, with $858M spent on mental health according to a 2006 report, Texas ranks 47th nationally in per-capita mental health spending, with an average of $39.02 per capita. In comparison, New York ranks 3rd in per-capita spending at $192.07, and California ranks 14th in per-capita spending at $109.34.

In Texas, very little is known about the financing and delivery of mental health care services at hospitals and clinics beyond state funding for local mental health clinics. This report shows that a significant amount of mental health care, most of it supported by local tax collections, is being provided by the largest public hospitals in Texas.

The ten largest hospital districts report spending a total of $54.2 M for inpatient and outpatient mental health services in FY 2006, of which nearly $37.1M is unreimbursed. Three of the 10 hospital districts provide an additional $5.5M in funds to local mental health agencies that provide outpatient mental health services in the community.

The hospitals in these 10 districts see at least half of all psychiatric emergency visits reported in their county, indicating that these public hospitals are viewed as the entry point to emergency mental health care. Most of these hospital districts have inpatient psychiatric beds or contract for inpatient psychiatric services at other facilities for indigent patients. Most of the hospital districts also provide varying levels of outpatient mental health services.

This comprehensive report sheds light on the magnitude of publicly-funded mental health care provided at the local level in Texas.

3. Primary Care and Indigent Health Care Comparison Report



Both indigent care and primary care services require significant expenditures that are primarily supported by local taxes. Texas statute holds hospital districts responsible for providing health care to indigent residents. The 10 hospital districts included in the report serve half of the population in Texas and provide more than $1B of health care to indigent patients.

Unlike stand-alone public hospitals, these hospital districts provide extensive outpatient primary care services, where many indigent patients have their primary care home, spending $392M in FY 2005, of which $332M is unreimbursed.

For primary care services, the report details:

• Costs, reimbursement, and payor mix
• Descriptions of services
• Patient volume
• Structure and ownership of clinics

For indigent health care, the reports details:

• Program enrollment
• Program benefits
• Eligibility guidelines
• Patient responsibility for payment.

4. Inmate Health Care Comparison Report



More than 30,000 inmates, most of whom are in need of physical and/or mental health care services, are incarcerated on any given day in the county jails in the 10 largest counties in Texas. Eight of the 10 largest hospital districts in Texas spend more than $41 million annually on inmate health care programs.

The report provides information on the following:

• The incarcerated population in each hospital district
• Inmate health care services in county jails
• Administration and funding of inmate health care services