The new year has been chaotic for hospital nonprofit Ascension Texas, the former Seton Healthcare. Through most of January, Ascension and Blue Cross Blue Shield of Texas, the largest health insurer in the region, were in tense negotiations over what Blue Cross will pay for Ascension’s services to its 66,000 members, with a Feb. 1 deadline. Ascension wanted more money, Blue Cross says Ascension’s already too expensive, but the hospitals announced an agreement last week. Blue Cross followed with a Jan. 30 statement from BCBSTX President Jim Springfield: “As a customer-owned health insurance industry leader, we must protect BCBSTX members’ access to care at fair rates. This new contract reflects our mutual commitment to quality, affordable health care.”
Meanwhile, to ring in the new year, The New York Times published a powerful exposé on Ascension’s padded executive salaries and understaffed hospitals across the country, where patients linger without care and overworked nurses struggle. Austin’s recently unionized nurses at Seton Medical Center report similar conditions; on Jan. 26 they held a candlelight vigil outside Ascension Texas’ headquarters in Mueller to protest the preventable loss of life caused by understaffing.
Local labor leaders and U.S. Rep. Greg Casar lent support as nurses described Ascension’s “cold shoulder” in response to their concerns. Current policy is to hold up to 20% of a unit’s positions vacant, and in fiscal year 2021 Ascension’s net profit was $6.4 billion, “so we are very confused when our staffing levels are not to par.” This is hard on the nurses, which adds further staffing pressures, but those at the vigil highlighted increased risks to patients – longer stays and readmissions, preventable medical errors and avoidable complications, and “even potential death while under our care.”
This is particularly true in obstetrics; Seton has one of Austin’s busiest labor and delivery units and has seen a steady increase in deliveries since 2021. Nurse Kellen Gildersleeve, in a written statement delivered to Ascension management last week, detailed the “extremely precarious” state of the High-Risk Labor and Delivery unit and the increased risk of obstetrical hemorrhage, the leading cause of preventable pregnancy-related deaths in the state. “During an obstetrical hemorrhage, seconds matter.”
Gildersleeve continued that during summer 2022, the HRLD unit had to indefinitely cancel elective inductions – considered a “risk-reducing” procedure – for months, and delay cesarean sections by hours “or even days” because of inadequate staffing.
In a statement, Ascension called last week’s vigil “a bargaining tactic,” referred to its “robust workforce development program,” and said it will “continue to negotiate in good faith” with the nurses.
The same theme – Ascension wanting more money to deliver less care to (and with) fewer people – is at the core of its legal dispute with Central Health, as we reported last week. At issue are about $80 million per year in federal funds that Central Health directs to Ascension, under the terms of a 2013 agreement, to cover safety-net care, including for patients in Central Health’s Medical Access Program. Ascension says the MAP rolls have grown from 25,000 to 29,000 (true!), so it wants more money. Central Health says Ascension has never treated more than 18,239 MAP patients in one year, and now treats fewer than 15,000. (Also true! At least that’s the data Ascension shared with Central Health.)
The health care district’s positions on this major breakup can now be explored online at healthcarejusticefortraviscounty.org.
This article appears in February 3 • 2023.