An innovative approach to the way health care providers treat burns and trauma patients is being led by The University of Texas Medical Branch at Galveston as part of a program that assists uninsured, indigent and Medicaid patients throughout the state of Texas.
Called the Texas Medicaid 1115 Waiver Delivery System Reform Incentive Payment program, its goal is to transform the way care healthcare is delivered. It allows the state to help those on Medicaid while preserving hospital funding, provides incentive payments for health care improvements and directs funding to hospitals with large numbers of uninsured patients.
One project under the 1115 Waiver program deals specifically with burns and trauma which provides UTMB-led education and training to community hospitals and emergency medical services. Expert UTMB health care providers visit with these groups in the partnership to teach important steps and techniques in treating burn and trauma patients.
“I think the impact is significant because what we’re seeing is a lot of community hospitals trying to help their patients and do what’s best for them but they delay the care they need,” said Dr. Carlos Jimenez, a burn surgeon in the UTMB Blocker Burn Unit. “If we can get those patients here earlier, it’s huge.”
UTMB is the anchor for the Regional Healthcare Partnership 2, which includes 16 counties from Galveston and Brazoria, along the eastern Gulf Coast, and east Texas as far north as Nacogdoches and Shelby counties, with a total of 1.5 million people over an area of nearly 14,500 miles.
Funding made available for the region under the 1115 Waiver is approximately $300 million for 83 different projects with UTMB set to receive around $190 million for 31 of those. Projects must be successful to receive funding. If successful, the burn and trauma project will receive nearly $1.9 million.
The first 24 to 48 hours are crucial for burn patients. If community hospitals treat patients properly and quickly transfer them to a burns and trauma center such as the Blocker Burn Unit at UTMB, it can increase likelihood of survival, shorten length of hospital stays and lower hospital bills.
Those involved with the 1115 Waiver burns and trauma project see optimistic change. For the 2015 federal fiscal year, 171 health care providers have been trained through the waiver program and 227 Medicaid and self-pay patients have been served. UTMB tracks every trauma and burns patient that has been seen by a trained provider during their transportation transfer or self-referral to UTMB.
The 1115 Waiver allows better access to care for burns and trauma victims that might be self-pay or on Medicaid. The Blocker Burn Unit has the highest survival rate of patients with major burn injury of all hospitals in the U.S. According to patient data collected for the 1115 Waiver, UTMB has seen a decrease in mortality rates since the implementation of the program.
“It’s important for early recognition and early referral,” said Jimenez. “The most common problem is providers fail to recognize the severity of the injuries and they cannot delay and keep their patients for whatever reason. That’s what we’re trying to improve.”