When Baylor Medical Center at McKinney opened its doors in July 2012, the approximately $200 million facility was a concrete-and-steel manifestation of Collin County’s population growth. Its six-story, modernist main building housed 95 beds that quickly filled with patients. To keep up, the hospital increased its staff by 50 percent, to 550 employees. Baylor executives figured they might begin to explore expansion about two and a half years after opening. In fact, they had to begin that process before 2012 even ended. Scott Peek, the hospital’s president, says the surprising patient volume was especially high in the emergency department (ED), where the beds were among the most frequently occupied in the Baylor system. They will add 12 ED beds by the end of the summer, doubling current capacity, and another 48 beds by the end of this year.
Now take that one example and imagine the same thing happening in every corner of the county. Methodist Richardson will open a 209-bed hospital this month. (It is located in Dallas County, but more than a third of its patients will come from Collin County.) HCA’s Medical Center of Plano is spending $66 million to expand its West 15th Street campus by the end of 2014 and recently opened a satellite ED. And Texas Health Resources is opening a Ben Hogan Sports Medicine facility in Frisco and is expanding mental health services at Texas Health Presbyterian Hospital Plano.
The Collin County health care gold rush is an attempt to capitalize on explosive population growth and favorable demographics. The numbers tell the story.
Population: Frisco and McKinney are among the top 15 fastest-growing U.S. cities. A recent highway study estimated Collin County’s population topping 2 million by 2030. The current population is “just” 835,000 residents, but it grew 61 percent between 2000 and 2011, making it the 13th-fastest-growing county in the United States.
Education: Nearly 50 percent of Collin residents have at least a bachelor’s degree, which is almost double the rate for Texas and the United States.
Income: The county’s 2011 median household income of about $82,000 is more than 40 percent higher than that of the rest of the country.
Health: Education and income are tied tightly to good health. So it is no surprise that Collin County is ranked No. 2 in Texas in the University of Wisconsin Population Health Institute’s County Health Rankings. The county is ranked No. 3 in clinical care.
Bill Bilyeu, Collin County administrator, says many of the county’s newer residents are younger than the national average, which contributes to Collin’s favorable health profile. That fact also contributes to baby making. Methodist, Texas Health Resources, and Baylor all have, or are, expanding women’s health services to accommodate those of child-bearing age.
Robert Rankins, an emergency medicine physician who owns E-Care Emergency Center locations in McKinney and Frisco, says physicians are attracted to the area because of the county’s high percentage of privately insured patients. The hospital expansion in the county has likely siphoned off some of Rankins’ urgent-care customers, but he says he hasn’t noticed because of the steady stream of new patients moving to the area. A lot of these young, affluent families, he says, prefer not to establish a relationship with a family physician. “They pull in, want to be taken care of, and then go home,” Rankins says. “They don’t want a medical home.”
That desire for convenience has given rise to another Collin County trend, the “medical village.” Dr. Christopher Crow has a national reputation for reimagining comprehensive primary care with a company he co-founded called Village Health Partners in Plano. His original location was Legacy Medical Village, where about two dozen specialty practices operate under one roof. Patients can see a doctor, fill prescriptions, get lab and imaging services, and even see a consulting surgeon in less than half a day, all without leaving the 100,000-square-foot facility. He has established two other medical villages in Plano, has plans for one in McKinney in 2014, and other Collin County locations in the next three years. His practices now take care of about 75,000 patients every year.
“We have master-planned communities and master-planned recreation in Collin County,” Crow says. “Why not master-planned health care?”
Underlying all the bullish data, though, there is one troubling stat coming out of Collin. Despite the county’s relative affluence, it still has an uninsured rate roughly equal to the rest of the nation’s. In a 2013 Health Affairs blog post, professors from Harvard and Vanderbilt contrasted Plano with Revere, Massachusetts, a blue-collar suburb of Boston. Revere’s average household income was only 60 percent of Plano’s. Yet both cities had uninsured rates of 10 percent.
In 2011, Crow’s Village Health Partners and the medical society launched Project Access–Collin County (PACC). Local physicians and hospitals donate their time and resources to treat nearly 200 uninsured residents. PACC—made up of 100 doctors from all nine major health hospitals—provided about $1 million in services to indigent and uninsured residents last year. It pays PrimaCare urgent clinics to provide primary-care services at its five county locations, and it underwrites treatment at seven other nonprofit medical clinics.
Margaret Langteau, chair of the Healthcare Committee of Collin County, says her group is pushing for Medicaid expansion under the Affordable Care Act because about 150,000 county residents don’t qualify for the government program or participate in the exchange. Her group is also seeking to bring a federally qualified health center into the county to serve low-income patients on a slide-fee scale.
“Collin County has grown so aggressively that we now have a mix of demographics that we didn’t have before,” Langteau says. “The health-care system works well for some, but there are a lot of people who are left out.”