ANNUAL REPORT The Baylor Health Care System Difference Our accomplishments in Commitment, Reform & Growth
Table of Contents Fueling the Regional Economy Letter from the President and CEO BHCS Map Commitment Reform Growth 1 3 4 5 10 16
Fueling the Regional Economy Baylor Health Care System has a major impact on the health and economy of North Texas. Here are our numbers from 2012: $539 million: commun 409,375 ED visits 2.8 million patient encounters 21,883 employees more than 370 patient access $5.3 billion: $3.8 billion: total $335 m the largest based on patient encounters and 1
points ity benefit 3,572 licensed beds total assets net operating revenue illion: capital expenditures not-for-profit health system in North Texas access points 19,859 babies delivered 4,732 physicians on medical staff BaylorHealth.com/BHCSAnnualReport 2
Letter from the President and CEO Letter from the President and CEO: In the coming years, health care will undergo intensive transformation unlike anything we have ever experienced. Health care reform will require new approaches to the way patient care is delivered. Yet in that ever-changing environment, we cannot lose sight of the need to provide the highest quality care for our patients, at a reasonable cost. But there is good news for North Texans Baylor Health Care System is up to the challenge. Instead of waiting for changes to be imposed on us, in 2010 we created Vision 2015, a new model of health care to prepare us for the implications of health care reform. And now, we are leading the way. Baylor is changing health care for life. Over the past several years, we have shifted our focus from sick care to wellness and preventive care, even as we advance the science of medicine. We are treating patients proactively to create better health for populations at risk. We are working with other health care organizations to adopt best practices and new, expanded measurement standards. And we are creating a delivery model where physician practices support value-based care. We are leading change by continuing what we ve always known. We re committed to people whether it s our patients, our providers, our friends and neighbors in the community, or the world at large. We continue to put our patients at the center of everything we do. It is our commitment to being trusted as the best place to give and receive safe, quality, compassionate care that motivates us to serve you day after day. Baylor has a 110-year history as a ministry of healing, which will continue even during times of change. Our vision for changing health care for life means staying true to our mission and our values. And it s working. In 2012, we gave back $539 million in community benefit to meet the health care needs of North Texas. Part of that funding went to continue our efforts at the Diabetes Health and Wellness Institute in southern Dallas. Thanks to this program, our neighbors in one of Dallas County s most underserved areas have access to diabetes education, management, treatment and preventive care. They also have a patient-centered medical home to call their own. We expanded our network to make an impact in more communities. In 2012, we opened Baylor Medical Center at McKinney and we built a new tower at Baylor Regional Medical Center at Grapevine. In addition, we are spreading centers of excellence across our System in building a cancer network dedicated to providing the level of quality care patients receive at the new Baylor T. Boone Pickens Cancer Hospital and Charles A. Sammons Cancer Center on the campus of Baylor University Medical Center at Dallas. Perhaps most important, Baylor Health Care System has merged with Scott & White Healthcare in Central Texas. By joining forces and sharing best practices, we can extend our reach and connect with more patients in new and meaningful ways. Baylor is changing health care for life. And you are at the center of our decisions during this era of reform. Our patients are the heart of our mission and vision. Providing quality care is our calling. It is a ministry of healing. It is a promise. And that is one thing that never changes. This annual review is a look back at our accomplishments and a look ahead to what you our patients, our providers, and our communities can expect from Baylor in the years to come. Joel T. Allison President and Chief Executive Officer Baylor Health Care System 3
Mapping Baylor 30 380 35E 23 380 12 18 16 Frisco 5 75 McKinney 380 114 35W 19 Grapevine 121 8 Plano 24 2 29 190 30 75 28 7 3 30 27 Legend: 1 Owned/operated hospitals 2 Joint ventured hospitals 3 Affiliated hospitals 35W Fort Worth 25 1 15 21 287 380 635 26 4 30 20 67 17 35E Dallas 22 31 9 20 13 10 11 3 14 Waxahachie 6 45 635 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Hospital Locations: Baylor All Saints Medical Center at Fort Worth 1 Baylor Medical Center at Carrollton 1 Baylor Medical Center at Garland 1 Baylor Medical Center at Irving 1 Baylor Medical Center at McKinney 1 Baylor Medical Center at Waxahachie 1 Baylor Regional Medical Center at Grapevine 1 Baylor Regional Medical Center at Plano 1 Baylor Specialty Hospital 1 Baylor University Medical Center at Dallas 1 Our Children s House 1 Baylor Emergency Medical Center at Aubrey 2 Baylor Jack and Jane Hamilton Heart and Vascular Hospital 2 Baylor Institute for Rehabilitation (BIR) 2 BIR at Fort Worth 2 BIR at Frisco 2 BIR at North West Dallas 2 Baylor Medical Center at Frisco 2 Baylor Medical Center at Trophy Club 2 Baylor Medical Center at Uptown 2 Baylor Orthopedic and Spine Hospital at Arlington 2 North Central Surgical Center 2 The Heart Hospital Baylor Denton 2 The Heart Hospital Baylor Plano 2 Baylor Surgical Hospital at Fort Worth 2 Irving-Coppell Surgical Hospital 2 Glen Rose Medical Center 3 Hopkins County Memorial Hospital 3 Hunt Regional Healthcare 3 Wise Regional Health System 3 Baylor Research Institute 4
5 COMMITMENT
Commitment Giving from the Heart Baylor s commitment to serving all people is evident through our giving. Serving the community is our calling. We serve because it is the right thing to do. It is proven in our history as depicted in the photo to the right when Baylor nurses treated children from Buckner Orphans Home at Texas Baptist Memorial Sanitarium s free clinic and it will remain in our future. Other Community Benefit: $3.3 million In Kind & Other Financial Donations: $788,279 Subsidized Health Services: $4.2 million Research: $12.7 million Medical Education: $29.3 million Caring, Now More Than Ever Baylor is absorbing more of the cost of caring for the community than ever before. From July 2011 to June 2012, Baylor Health Care System gave back 13.7 percent of net patient revenue $539 million nearly three times more than required by state law. Our reinvestments in the community seek to improve access to care, enhance community health, advance medical education and technology, and relieve the burden of care borne by the government and other providers. Baylor s commitment to our community is unwavering. Amounts in pie chart represent those reported to the Texas Department of State Health Services. Unreimbursed Cost of Charity Care/Unreimbursed Medicare: $297.2 million Cost of Medicaid: $192 million BaylorHealth.com/BHCSAnnualReport 6
Commitment Giving and Healing Much of what we do relies on the generosity of our donors. In FY 2012, Baylor s three foundations Baylor Health Care System Foundation, Irving Healthcare Foundation and All Saints Health Foundation distributed more than $30 million to the System. These gifts enable us to serve our patients and the community, undertake innovative research and fund medical education to meet our region s growing demand for health care professionals. Attracting Quality Medical Talent This year, Baylor and the Texas A&M Health Science Center College of Medicine developed a clinical training program that allows students to complete their last two years of medical school in Dallas. In addition, Baylor University Medical Center at Dallas hosts elective rotations for fourth-year medical students from more than two dozen accredited medical schools. Our elective clinical and academic training programs prepare students in diagnostic radiology, internal medicine, obstetrics and gynecology, pathology, physical medicine and rehabilitation, and general surgery. Pictured left, Cristie Columbus, MD, vice dean (center) with students in the Texas A&M Health Science Center College of Medicine. 7
A Beacon of Hope In southern Dallas, Baylor is improving the health of a population with the highest rates of diabetes in Dallas County, along with severe risk for many other chronic diseases. Our $15 million Diabetes Health and Wellness Institute at Juanita J. Craft Recreation Center a joint effort with the City of Dallas provides a blend of clinical services, health education and recreation, making it one of the nation s most innovative diabetes management centers. Since it opened in 2010, the Diabetes Health and Wellness Institute has helped its patients and the community become aware of diabetes and change their lifestyle habits for a better quality of life. 43% achieved an optimal A1C blood sugar level 41% achieved blood pressure control 45% achieved optimal cholesterol levels BaylorHealth.com/BHCSAnnualReport 8
Commitment Faith In Action Baylor s Faith In Action Initiatives (FIAI) empower our employees for local and international medical service programs. FIAI s Second Life Resources Warehouse collects and repurposes medical equipment for other health care providers in need. In 2012, FIAI brought $132,912 worth of supplies and equipment to more than 31 countries for disaster relief and medical missions. Where we ve been 9
REFORM BaylorHealth.com/BHCSAnnualReport 10
Reform Who Will Lead the Way? How will Baylor lead through an era of unprecedented health care reform? We will focus on our patients. We will continue to emphasize wellness and prevention. And we will be an example of safe, quality, compassionate care. In alignment with the Institute of Medicine, Baylor is transforming the patient experience and creating a model of care for the future of our industry. BAYLOR WILL 11
Organize and develop population health management strategies Preserve our reputation as a top-rated health care system through stewardship and quality Develop medical centers of excellence to improve the health of the communities we serve Continue to pursue excellence in education and research Influence health care reform through patient-centered models of care Improve clinical practices to create an ideal experience for patients and caregivers BaylorHealth.com/BHCSAnnualReport 12
Reform Baylor Quality Alliance As of January 2013, BQA serves approximately 33,000 employees and dependents of Baylor Health Care System, as well as patients with Medicare Advantage plans under Humana and Aetna. With nearly 2,200 physicians, BQA is making strides to prepare for changes now required under federal health care reform. Initially, BQA has implemented four main objectives: 1 2 3 4 Increase the use of generic drug prescriptions Reduce unnecessary imaging for common low-back pain Minimize avoidable hospital readmissions Focus resources on the care of its sickest patients What methods help accomplish these objectives? First, physicians who join the BQA are helping to develop new protocols for many clinical conditions, which will improve quality, reduce cost of care and result in a lower out-of-pocket cost to patients. For the sickest patients, trained nurses, known as health coaches, help maintain a constant relationship with patients to help them fill prescriptions, follow treatment plans, seek a healthy, active lifestyle including diet and exercise, and assist in making follow-up appointments. A nurse health coach works closely with the primary care physician at a patient s medical home. Focusing the efforts of health coaches on very sick chronic disease patients minimizes avoidable hospital readmissions. Finally, all clinicians and physicians in the BQA will be connected through a network called a health information exchange. This pulls data from the electronic health records used in each medical office in the BQA to a centralized location. This infrastructure among providers will not only improve communication, but will allow BQA to analyze data for patient populations and make changes to care that will lower costs and improve quality. Additionally, physicians in the BQA will be informed on how they measure up to other doctors on the objectives in place. 13
Patient X Acute, Uncomplicated Patient Scenario 1 Patient X visits her primary care physician with a complaint of low-back pain. She reports the symptoms began occurring some time ago, but flared up after helping her son move into a new dorm room, during which she was lifting heavy boxes and moving furniture. 2 Before the BQA, Patient X s physician may have scheduled her to have an MRI (magnetic resonance imaging). Recent medical evidence shows that unnecessary imaging adds wasteful costs and can lead to potentially harmful interventions. 3 Patient X s physician is a BQA physician who recommends she take preventive measures to minimize her risk for worsening her back pain, such as avoiding lifting heavy objects. 4 Over the next two weeks, Patient X s nurse contacts her two to three times to make sure the pain medicine prescribed is helping and to see how she is doing with her exercises. Patient X is happy to tell her nurse that the pain in her back has significantly subsided. 5 All in all, this treatment plan resulted in a successful clinical outcome and reduced Patient X s out-of-pocket costs by eliminating an unnecessary imaging procedure and using a generic drug prescription. BaylorHealth.com/BHCSAnnualReport 14
Patient Y Chronic, Complicated Patient Scenario 1 Patient Y is a 76-year-old male with several illnesses, including congestive heart failure. After a visit to the hospital for acute worsening of heart failure, Patient Y s primary care physician asks him to schedule a follow-up appointment with a cardiologist. He is also prescribed six new medications. As a patient of a BQA physician, Patient Y is introduced to a RN Health Coach who is available to help him with his treatment plan. 2 Patient Y returns home and struggles to remember the exact directions that his doctor provided. His wife is worried as he is already on several other medications. She also cannot schedule a follow-up appointment for another month. Everything starts to feel very overwhelming. 3 The following day, Patient Y s nurse health coach calls to see how he is doing. Patient Y tells her about his confusion and struggles. The health coach helps Patient Y create a schedule for his medications and recognizes some duplications in medication that could be harmful if taken together. She calls his physician, who was not told about the other medications. Together they are able to eliminate three of Patient Y s daily medications. The health coach also calls the specialist to move Patient Y s appointment to the next week. 4 As a member of Patient Y s care team, the nurse health coach educates Patient Y and his wife on decreasing the salt intake in his diet to help deter symptoms of congestive heart failure. The health coach also asks Patient Y to check his weight daily. 5 One day, Patient Y notices he has gained 4 lbs and is experiencing shortness of breath. He calls his nurse health coach. She advises him to immediately go to his primary care physician. There he receives a diuretic that will relieve the water pressure in his body due to eating too much salt. This quick intervention helps Patient Y lower his blood pressure, thereby preventing a potentially dangerous cardiac event and avoiding a trip to the emergency department. 15
GROWTH BaylorHealth.com/BHCSAnnualReport 16
Growth Extending Care Through Growth For Baylor Health Care System, growth means extending our reach, broadening our vision and strengthening our service. It means helping more patients and changing more lives. Today, we re more flexible, more responsive and better equipped to share our ministry of healing. Quality at Every Touchpoint Baylor operates 30 hospitals and more than 370 patient-care access points across 12 North Texas counties for you. In 2012, these Baylor hospitals were recognized for excellence as health care providers, employers, community partners and industry leaders. These honors affirm our direction and strengthen our resolve to put you, our patients, at the center of every decision we make. 17
Growth Announcing Baylor Scott & White Health Today s demands for health care reform call for a huge response. Baylor Health Care System and Scott & White Healthcare intend to meet that challenge by creating an $8.3* billion organization that will bring together the best practices of both health systems. While Baylor Scott & White Health is the largest not-for-profit health system in Texas and one of the largest in the nation, we know it is more than that. It is an opportunity to increase access to care while bringing Baylor s ministry of healing to more communities in need. Learn what Baylor Scott & White Health will mean for you our patient by visiting BaylorScottandWhite.com. *based on unaudited fiscal year 2013 financial statements Joel Allison (left) is chief executive officer and Bob Pryor, MD (right) is president, chief operating officer and chief medical officer of the new organization, Baylor Scott & White Health. Gary Brock (not pictured) is now president and chief operating officer of Baylor Health Care System. BaylorHealth.com/BHCSAnnualReport 18
Growth Baylor Charles A. Sammons Cancer Center This 10-story outpatient facility is an advanced nexus for healing, learning and research. Innovative in its design, materials and approach, the center creates a holistic healing environment for patients and a collaborative setting for physicians and scientists. Since it opened, Baylor Sammons Cancer Center and its sister facility, Baylor Cancer Hospital, have become the second-largest provider of cancer services in Texas. In 2012, more than 8,000 patients came to us for more than 80,000 visits. This facility is also home to Baylor Annette C. and Harold C. Simmons Transplant Institute, lead by Göran Klintmalm, MD. It is one of the largest multi-specialty transplant centers and the third-largest heart transplant center in the country. Treatment as Unique as Every Patient Each cancer is as individual as the patient. For cancer, heart disease and other conditions, physicians at the Baylor Precision Medicine Institute craft customized responses as unique as a person s genetic code. For patients already undergoing treatment and people whose family history may put them at increased risk for disease the institute explores every option for treatment and prevention. The personalized journey is guided by a specially trained navigator who works closely with the patient and family. 19
Growth Giving Cancer The Fight of Our Lives Baylor continues to help patients battle one of humanity s greatest foes. In 2012, Baylor T. Boone Pickens Cancer Hospital joined Baylor Charles A. Sammons Cancer Center to provide the largest cancer treatment resource in North Texas. With quality care measured against national standards, our hospitals in Fort Worth, Garland, Grapevine, Irving, Plano and Waxahachie received certification from the American College of Surgeons Commission on Cancer and now bear the Sammons Cancer Center name. By uniting our expertise and innovation in cancer care, we re reaching patients across North Texas and beyond. Baylor T. Boone Pickens Cancer Hospital Baylor T. Boone Pickens Cancer Hospital, the first dedicated cancer hospital in North Texas and the second in the state, began opening in January 2012. Linked to Baylor Sammons Cancer Center on the Dallas campus, Baylor Cancer Hospital provides a new blood and marrow transplant (BMT) unit, a BMT processing lab, an apheresis/infusion center, an oncology evaluation and treatment center for emergency care, three new nursing units, palliative care services and an imaging center. A food-services unit preparing conciergestyle dining as well as washer, dryer and shower facilities for families and caregivers are among other amenities offered. Pictured at left, T. Boone Pickens, with Becky Hotchkiss, rings celebratory bell during news conference announcing his gift and naming of Baylor T. Boone Pickens Cancer Hospital. BaylorHealth.com/BHCSAnnualReport 20
View the entire Fiscal Year 2012 Annual Report at BaylorHealth.com/BHCSAnnualReport Physicians are members of the medical staff at one of Baylor Health Care System s subsidiary, community or affiliated medical centers and are neither employees nor agents of those medical centers or Baylor Health Care System. Photography may include models or actors and may not represent actual patients. 2013 Baylor Health Care System 3500 Gaston Avenue Dallas, TX 75246 1.800.4BAYLOR BaylorHealth.com BHCSAnnualReport BHCS_855_2012.MOROCH.9/913