31 Days, 31 Ways: Budget Cuts Force Downgrade of Trauma Center

Throughout the month of August, The Texas Tribune will feature 31 ways Texans' lives will change come Sept. 1, the date most bills passed by the Legislature — including the dramatically reduced budget — take effect. Check out our story calendar here. 

Day 7: Cuts in reimbursement rates have forced the East Texas Medical Center to downgrade its trauma center in Athens from Level III to Level IV.

During the 2011 legislative session, lawmakers voted to reduce reimbursement rates to hospitals around Texas. As a result,the East Texas Medical Center, which operates 11 affiliate hospitals, plans to downgrade its trauma center in Athens from Level III to Level IV.

ETMC officials say their system is seeing a growing demand for services. But they say they don't think they can absorb an estimated 6 to 7 percent reduction in state and federal reimbursement rates. System-wide, they estimate that's a loss of $60 to $70 million over the next biennium.

"We are going through every aspect of our services, asking: Can it be done better, less expensively, more efficiently or can it continue to be done at all?" ETMC spokeswoman Christine Rutherford wrote in an email to the Tribune. 

Rutherford says Athens is one of the smallest communities in the state served by a Level III trauma center, which requires orthopedic and general surgeons to be on call 24 hours a day, seven days a week, 365 days of the year. Maintaining that level of staff costs the hospital about $500,000 every year. 

"For years ETMC has covered that subsidy to provide the Level III trauma care in Athens. With the estimated cuts to our revenues, this is no longer feasible for us as an organization," Rutherford said.

So what will the downgrade mean for ETMC-Athens patients? Starting Sept. 1, the hospital plans to keep two general surgeons and two orthopedic surgeons on call two-thirds of the time. If those surgeons are not available, patients will be transported to the Level I trauma center at ETMC's Tyler location, which is 30 miles away. If necessary, patients could be transported via an Air 1 emergency helicopter kept at the Athens hospital and maintained by EMS services in Henderson County. 

Rutherford reports that about 16 percent of patients in the Athens emergency room "meet the definition of trauma patients." So far, the hospital estimates no more than 5.3 percent of those trauma patients will need to be diverted to ETMC-Tyler.

Resources:

East Texas Medical Center locations and services

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