Cheyenne, WY—Results from the first 18 months of Wyoming’s Medical Neighborhoods Transform Rural Care Delivery Initiative show that the statewide effort is successfully extending a perimeter of health around Wyoming communities as hospitals and providers collectively focus on keeping patients healthy and ensuring that they are treated in appropriate care settings.
Funded by a three year, $14.2 million Health Care Innovation Award from the Centers for Medicare and Medicaid Innovation (CMMI) to the Wyoming Institute of Population Health, health care professionals across the state are working together to address the challenges of a reforming health care environment. The Wyoming Department of Health has also provided funding ($250,000) to support the development of patient-centered Primary Care Medical Homes (PCMH)s in the medical neighborhood.
Projected to save Wyoming an estimated $33 million in healthcare costs over three years, the initiative’s five component strategies have been designed to ensure that patients achieve the greatest possible care experience and benefit from well-coordinated, effectively communicated care and seamless transitions between care providers and facilities
Five Key Components of a Medical Neighborhood
At the core of the medical neighborhood model is the Patient-Centered Medical Home (PCMH). A PCMH is a powerful primary care model that focuses on superior access to care; wellness and disease prevention; chronic disease management; and care coordination across sites of care. The PCMH acts as the central point of contact for the patient and primary coordination of the patient’s care with various healthcare “neighbors” that may consist of multiple sites of care and service based on the patient’s needs. To date, 28 primary care practices in Wyoming have implemented the PCMH model, and are reporting improved clinical outcomes associated with chronic disease management and preventive screenings. Collectively, these 28 practices represent more than 50% of Wyoming primary care providers and care for 60% of Wyoming’s Medicaid population.
To address gaps in care coordination, the Wyoming Rural Care Transition Program has trained and placed 28 registered nurses who are now working in 14 hospitals to provide coaching resources to patients for up to ninety days as they transition between acute sites of care and learn important self-care techniques to help them deal with chronic illness. More than 1,900 at-risk patients were assisted by Care Transition Nurses in 2013. Readmission rates are now below 9% in the majority of the care transition sites, compared to a national average of 21% for this population.
As a strategy to bridge geographic distances between patients, doctors, and specialists, the Medical Neighborhoods initiative is promoting the use of the Telehealth Physician Desktop Solution, which deploys state-of-the-art videoconferencing technology in hospitals and doctors’ offices. This communication network supports collaborative health care, improved care access for patients and educational opportunities for health care providers. Today, clinical Telehealth consultation is on the rise across Wyoming. 18 hospitals have completed an upgrade to high definition endpoints and six more are expected to be deployed over the next 18 months. A total of 187 desktop systems featuring webcam and mobile device connections have been installed.
Nine pharmacists and seven pharmacies have joined the Virtual Pharmacy program to provide a medication therapy management link between patients and the PCMHs in Casper, Cheyenne, and Jackson. The program utilizes Telehealth technology to facilitate communication between the pharmacist, patient and health care provider to optimize medication adherence, better monitor side effects and improve medical outcomes.
Additional support for medication adherence comes from the statewide expansion of the Wyoming Medication Donation Program, which accepts donated sealed, indate medications and provides them to eligible uninsured and underinsured lowincome patients. This Medical Neighborhood resource has dispensed more than 20,404 prescriptions to approximately 3,300 patients in these Medical Neighborhoods. The total value of the medications dispensed to-date is more than $1.26 million.
Phyllis Simpson Sherard, the Wyoming Institute of Population Health’s Principal Investigator, said, “Although we’re only halfway through the grant period, the Healthcare Innovation Award is already contributing to measurable improvements in the way healthcare is delivered in Wyoming. We’re optimistic about what the next year and a half holds as the participants continue to gain momentum.”Published Article Healthy Communities
Wyoming Medical Neighborhood Strategic Partners:
TransforMED® (Patient-Centered Medical Homes Strategy)
University of Wyoming School of Pharmacy (Virtual Pharmacists Strategy)
Cheyenne Regional Medical Center’s Telehealth Department (Physician Desktop Solutions)
The Wyoming Institute of Population Health (Wyoming Rural Care Transition Program)
Wyoming Department of Health (Wyoming Medication Donation Program)
Medical Neighborhood Participants: See attached
About the Wyoming Institute of Population Health™
The Wyoming Institute of Population Health, a Division of Cheyenne Regional Medical Center, is committed to building bridges between communities and health systems. The Institute was created to develop strategic platforms that proactively address the evolving needs of patients, communities, and health care providers across Wyoming.
Phyllis Simpson Sherard, PhD
Wyoming Institute of Population Health