The Greater San Antonio Chamber hosted the inaugural State of Healthcare this past week, bringing together San Antonio's healthcare leaders to discuss the historic growth in the sector and the significant challenges in the behavioral health segment.
Despite representing competing health systems, the panelists repeatedly emphasized a shared mission and collaborative spirit across the industry.
"We all serve the same city. We care for many of the same patients," said Trip Lyles, Group Chief Strategy Officer, Baptist Health System. "At the end of the day, it's not about a business deal—it's about patient care."
One of the strongest themes throughout the discussion was the tremendous growth occurring across San Antonio in response to the increased demand for healthcare services.
"We are currently experiencing the most rapid expansion in the history of our health system," said Dan Miller, President & CEO, Methodist Healthcare. "I often say Texas doesn't have a demand problem—it has a growth problem. Everybody wants to be in Texas, and everybody wants to be in San Antonio."
The numbers reflect that growth. Miller noted that Methodist Healthcare has more than doubled its annual patient encounters since 2019—from approximately 1.6 million to more than 3 million. During that same period, the system added five hospitals, 15 urgent care centers and two ambulatory surgery centers, with additional expansion announcements expected in the coming months.
Healthcare leaders agreed that the future of care increasingly extends beyond traditional hospitals, highlighting the growing importance of ambulatory, urgent care and outpatient facilities.
For Derek Cuenca, CEO, CHRISTUS Santa Rosa Westover Hills, expanding access means ensuring residents can receive care closer to home.
"We all participate in a community health needs assessment, and one of the clearest findings was the healthcare access gap on the West Side and South Side of San Antonio," Cuenca said. "The issue isn't just hospital access. It's ambulatory care access, primary care access and specialty care access."
CHRISTUS Health is investing in outpatient facilities, urgent care centers and primary care services in underserved areas, while also expanding specialty pediatric care through CHRISTUS Children's Hospital. The goal, Cuenca said, is to eliminate the need for families to travel across town—or outside the region—for routine or specialized care.
University Health President & CEO Ed Banos highlighted the critical role the public health system plays in caring for the community's most vulnerable residents.
"About 13% of our operations are funded through tax dollars," Banos said. "When you look at how those tax dollars are used, we provide roughly $400 million in direct care for the uninsured and underinsured."
Banos noted that University Health also invests heavily in medical education, research and specialized care through its partnership with UT Health San Antonio, helping ensure residents can access advanced treatment without leaving the region.
Asked what keeps him up at night, Banos offered a one-word answer: "Capacity."
"All of our hospitals are extremely busy," he said. "Patients expect timely access to care and high-quality treatment. The challenge is making sure we can continue providing that level of service while demand continues to grow."
Despite workforce shortages, reimbursement pressures and growing demand, the panelists expressed optimism about San Antonio's future, citing the region's collaborative spirit as a competitive advantage.
As the city's population continues to expand, healthcare leaders are betting that sustained investment, innovation and partnership will ensure San Antonio remains one of the nation's leading healthcare destinations.
Looming Behavioral Health Crisis
While panelists highlighted billions of dollars in healthcare investment and rapid expansion across the region, a second discussion focused on one of San Antonio's most pressing healthcare challenges: behavioral health.
Moderated by Mary Garr, President & CEO of Family Service, the conversation centered on the growing strain on the region's behavioral health infrastructure following the loss of approximately 330 psychiatric beds at the city’s only standalone psychiatric hospital.
"We now find ourselves in uncharted territory following the loss of Laurel Ridge's CMS [Centers for Medicare & Medicaid Services] certification and the resulting reduction in psychiatric bed capacity," said Eric Epley, Executive Director/CEO of STRAC. "That's a significant setback for our community."
Epley emphasized that mental illness affects every segment of society and should not be viewed solely as a homelessness issue. "One in four people will experience a mental health or substance use disorder," he said. "This is not just a homelessness issue. This is a family issue. This affects every community and every socioeconomic level."
The panelists stressed that San Antonio has developed one of the state's most innovative behavioral health crisis response systems through the South Texas Crisis Collaborative, a partnership involving healthcare providers, local governments, law enforcement agencies and community organizations. Programs such as STRAC's Law Enforcement Navigation Program now divert approximately 1,400 individuals each month from emergency rooms and jails to more appropriate behavioral healthcare settings.
Despite those successes, community leaders warned that additional investment is needed.
"The reality is that we have invested heavily in physical healthcare infrastructure," said Jelynne LeBlanc Jamison, President & CEO of the Center for Health Care Services. "However, we must also invest in behavioral healthcare."
Burley identified three critical needs: outpatient behavioral health services, psychiatric hospital capacity and wraparound support services. "Without all three, people will continue falling through the cracks," she said.
She also advocated for the creation of a diversion center that would provide treatment alternatives for individuals experiencing mental health crises who might otherwise enter the criminal justice system.
Dr. Rene L. Olvera, Professor and Chair of the Department of Psychiatry and Behavioral Sciences at the University of Texas at San Antonio, noted that the region's behavioral health challenges extend far beyond a shortage of psychiatrists.
"Patients need therapists. They need counselors. They need social workers. They need care coordinators," she said. "Medication alone is not enough."
He emphasized that transportation, housing stability, counseling and family support all play vital roles in helping individuals avoid behavioral health crises.
The panel concluded with a call for sustained investment in psychiatric capacity, outpatient services, diversion programs and wraparound care, emphasizing that San Antonio's long-term success depends on addressing behavioral health needs before they become emergencies.