2 min read February 2023 — Tarra Washington, CEO of Kindred Hospital San Antonio Medical Center, has extensive healthcare experience both in the US and in the UK, in particular, with specialty hospitals focusing on long-term acute care. In an interview with Invest:, she discussed the challenges with insurance coverage, creating a community for employees and the differences between the many markets she has worked in.
How has your experience in San Antonio been different from other regions?
Interestingly enough, New York, New Jersey and Philadelphia are very similar, all filled with many large health systems that are competing and focusing on innovation and the newest surgeries and technologies. When I was in the Kindred Hospital in Morris County, New Jersey, as the CEO, also a specialty hospital, we did a lot of business with the New York hospitals because they didn’t have and weren’t allowed to have our type of hospital in the state of New York. We would have these huge health systems sending us very complex patients. Our biggest issues in Philadelphia and New Jersey were the coverage from private medical insurance and those recognizing our type of hospital, helping them understand that our type of hospital was unique and not at all comparable to either a nursing home or a straight rehab facility. We were an acute care hospital that treated a very niche, and extremely sick, type of patient. They would compare our costs to a nursing home and say we were too costly for their patients to come to us, and instead, would discharge them to a skilled nursing facility. Our response was that instead, they should be comparing our costs to the larger acute care hospitals.
In regards to the UK, I saw major differences because everyone has the NHS, everyone has insurance and you can pay a little bit more for private health insurance. Big corporations would pay for their employees to have over and above the NHS so you often had double coverage for your medical needs. There was a huge push for adding a private healthcare element because the NHS was getting inundated right after COVID. It was just a completely different thought process. When I took the job here in Texas, I thought I would be back to doing what I used to do and that it would be similar. But Texas is a completely different market. I think the first factor is that the physicians function a little bit differently. In San Antonio, there are a lot of hospitals all in a very small area. I have competitors right down the street. You have larger hospitals building acute rehabs almost on every corner so you have all these sites kind of competing against each other and you’re fighting to get physicians, nurses and things of that nature. We’re this very specialized type of hospital for the sickest of the sick: people who are on ventilators for an extended period of time or those that require very complex wound care. The average person will never need our level of care. Often patients’ families learn about us when their loved one has been in the ICU for a period of time, have one or more complex illnesses, or are dependent on a ventilator. But we have to do better in educating the San Antonio community on what we do, and how we can provide intense medical care and recovery to the sickest patients when they don’t know where to turn for help.
How do you select the appropriate patients and navigate other hospitals’ offerings?
Promoting value versus number of patients is big for me. Now the thought process is focusing on identifying and promoting our particular value add against other hospitals or going out to the market and educating providers on what we do. It’s more about letting them know what we can provide and why we’re important. Most important is that you’re bringing in the appropriate patients and maintaining an appropriate level of care. We are thinking a little bit more about how to set ourselves apart, defining why we are the best of the best, being consistent in what we provide, and creating the best patient experience possible.
What opportunities or challenges have arisen in line with the area’s population growth?
I think the population growth in the area is an opportunity. We have the availability of beds, but educating others and getting them to understand that we are here, that we have expertise in treating the most complex patients, and that we can take these patients is important. Coverage for our level of care is also getting harder and harder. Even as our local population grows, there are so many patients who don’t have proper medical coverage. So, there might be a big population but they’re not insured. That’s a struggle for us because while we’re getting a whole volume of referrals to our hospital, it is unfortunate that patients can’t receive the appropriate level of care because they don’t have coverage, or their insurance is not allowing them to be admitted.
What’s the greatest difficulty you face in finding new patients?
The biggest challenge is the shift to people having particular insurance plans that don’t cover our level of care. The problem is that our level of care is very, very specific. We’re not asking for every patient; we provide a certain level of care for a patient who, for instance, may need respiratory care around the clock or may need wound-care-certified practitioners who round every day with physician oversight. We’re working to help these insurance companies understand that if they don’t cover our specialized hospital level of care, and the patient goes to a lower level of care many times, they end up bouncing back to the hospital and costing more. Oftentimes, we can’t even get a meeting to get that explanation across because the insurance company has simply made its final decision without considering the facts or the strong data supporting our significance for certain patients. That’s our biggest challenge: making sure we stay in front of these insurers so that they can understand what our value is and how important we are for the most challenging and complex patients.
For more information, visit:
https://www.kindredhospitals.com/locations/ltac/kindred-hospital-san-antonio
