Health-care trends shifting; new provider model needed

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Health-care trends shifting; new provider model needed

By George Schwarz

Amarillo Globe News, September 8, 2003

Editor's Note: These are two of a series of articles, "Which way to the future?" The stories are meant to give a look at the changing face of Texas and the Panhandle and what may happen down the road.

The demographic changes clearly coming to the Panhandle - a growth in the proportion of elderly and a younger Hispanic population - may provide new business and investment opportunities if money can be found to pay for health-care services.

And some of those services will look different.

"The old nursing home model is not going to make it," said Dr. David Thomason, vice president of public policy for the Texas Association of Homes and Services for the Aging. "Baby boomers and generations after the baby boomers are not going to want to be in a 'nursing home."'

Long-term caregivers are looking at models to keep people independent in the home or in a home-like environment, he said.

"The market is ripe for a strong entrepreneur," he said. "We're seeing there is a high demand for that type of service. It makes sense economically. Your return on your investment is a strong return."

That is, if there is a way to pay for it. The Medicaid cuts of Sept. 1 will reduce the capital to renovate the 1950s and 1960s-era facilities built on the old hospital model, he said.

The trends may be more sweeping than for West Texas, said Dr. Dr. Patti Patterson, vice president for rural and community health, Texas Tech University Health Sciences Center in Lubbock.

"We're going to see a lot of dynamics here and perhaps the whole Great Plains because these trends in aging and out-migration and increasing Hispanic in-migration are true here but all the way really to Canada if you look at the Great Plains states," she said. "But we're going to see them first."

Which Way To The Future

· Challenges: Increased need for health care in small towns with declining numbers of doctors but more elderly and Hispanics. Demand for a new type of nursing home.

· Possible Solutions: Towns banding together to get medical services. Attract investors to build new facilities.

· Consequences of Inaction: More visits to emergency rooms instead of doctors' offices. Continued use of aging facilities.

Small towns in rural areas, particularly in West Texas, will increasingly need health-care facilities and professionals when simultaneously those who provide care are less available, said Dr. Glen Provost, Texas Tech's vice president for policy and planning in Lubbock.

The tremendous economic implication is to make it harder to attract businesses that look for health-care services to support their workforce, he said.

As grim as the outlook may be, there is a chance to be creative, Patterson said. Several communities might consider banding together to lure primary care providers interested in practicing in rural communities. And, a greater use of technology could help make doctors available to nursing homes in the nine counties that don't have a doctor.

Thomason also said opportunities abound for smart marketers.

"Amarillo is becoming much more diverse and a lot of the marketing tools that these larger care facilities have focused on are primarily focused on the Anglo population," he said.

The population shift will require they refocus their attention on the unique parts of the Hispanic culture, he said.

One thing that won't change is the demand on hospitals, said Dr. James Rohrer Jr., a professor of health services research at the Texas Tech Health Sciences Center in Amarillo.

"The business opportunities are number-one square on medical care," he said. "You can sell a lot of services to the old people because they have a lot of diseases. But there's no doubt there's big money."

And while the focus may be on the elderly in one of the youngest states in the nation, the unfortunate part is that the often-uninsured Hispanic population will end up in hospital emergency rooms instead of getting primary and preventive care, he said.

Dr. Meganne Walsh, a local pediatrician, said there will be a greater demand for pediatric services, opening up job opportunities for nurse practitioners, child health associates or pediatric physician assistants.

Opportunities also exist for investments driven by the population, she said. Companies that make immunizations are a good bet. Those firms are developing new combinations of vaccine, new ways to move from painful "shots" to painless methods - a nasal spray, for example, she said.