CASPER, Wyo. — Wyoming Medical Center officials have been meeting with their counterparts at Cheyenne Regional Medical Center to create a statewide “accountable care organization,” the WMC’s chief executive officer said Wednesday.
That will require a cultural shift, in addition to changes in the ways the federal government reimburses hospitals for Medicare and Medicaid patients, Vickie Diamond said.
“We’re trying to create models that work for Wyoming,” Diamond said.
“We pride our independence, but this is a time for providers to come together,” she said at the monthly meeting of the board of trustees of the Memorial Hospital of Natrona County. The board, appointed by the Natrona County Commission, oversees the lease of the county’s hospital assets by the nonprofit Wyoming Medical Center Inc. The WMC’s rent, in effect, is to provide care for the indigent and inmates in the Natrona County Detention Center.
The discussions with the Cheyenne hospital began in 2010 after Congress passed the Patient Protection and Affordable Care Act, and have intensified as the paperwork piles up, Diamond said. “This is the year of regulation.”
The original act was a couple of thousand pages, but the regulations accompanying the act total 200,000 pages, she said. “We’re expecting more regulations to come out.”
An accountable care organization is a partnership among hospitals, doctors and other health care providers that receive Medicare reimbursements that agrees to be accountable for quality, cost and overall patient care, according to the Centers for Medicare and Medicaid Services. Medicare is the federal health insurance program for people 65 and older and for the disabled.
The first phase of an accountable care organization would maintain the traditional fee-for-service structure used by primary-care physicians and Medicare patients, and would assign Medicare patients to those physicians, she said.
Over the course of a year, the hospitals, physicians and other providers working with these patients would be expected to meet certain standards of care and patient outcomes while saving money, Diamond said.
And Medicare, by bundling its reimbursements to a single accountable care organization, would offer an incentive to do that.
The participating hospitals need to craft a legal structure to disburse the money, Diamond said.
In other matters, Diamond said the WMC’s expanded emergency room is completed.
“Hardly anyone is waiting very long,” Diamond said. “Patient satisfaction is up.”
Hospital officials are finalizing the cost of the next phase of the planned expansion but had to reduce the scope of the project to stay within its $35 million budget, she said.
Several departments have moved, utilities are being shut down, and asbestos is being removed in preparation for the demolition of a 1939 building to make way for a new tower, Diamond said.
“We hope to start tearing the building down in May.”
Don Claunch, the interim chief financial officer who replaced former CFO Nancy Brandt, said the hospital has spent $38 million on unreimbursed care — $24 million for charity care and $14 million written off as bad debt.
“We remain under budget,” Claunch said. “We’re watching that closely.”