The Longevity Project Part 3: Investing toward access: High country hospitals spend millions to increase residents’ access to care
Editor’s note: This is Part 3 of a four-part series on longevity in the High Country. The series is being produced in partnership with The Aspen Times, Vail Daily, Glenwood Post Independent, Summit Daily News and Steamboat Pilot & Today. Read more at SteamboatPilot.com/longevity.
STEAMBOAT SPRINGS — Across the high country and Western Slope, hospitals during the past two decades have significantly increased their offerings to patients through adding specialized medicine, technology and facility upgrades.
Patients living in more isolated and rural communities are experiencing less of a need to drive to the Front Range or other metropolitan areas for certain surgeries, treatments and other specialty or emergency care.
At UCHealth Yampa Valley Medical Center, the list of expansions, additions and upgrades during the past 15 years is extensive, from the Gloria Gossard Breast Care Center in 2014 and the Jan Bishop Cancer Center in 2017, to the Level III trauma center designation in 2018 and the opening of the Steamboat Surgery Center in August, which the hospital operates in partnership with Steamboat Orthopaedic & Spine Institute.
Today, Yampa Valley Medical Center CEO Soniya Fidler said many second homeowners wait until their time in Steamboat Springs to schedule appointments.
“We have some advanced technology unheard of even in larger cities,” she said, also emphasizing improvements to patient experience and noting patients come to the hospital in Steamboat Springs from outlying areas that may be just as close in proximity to the Front Range.
And it goes beyond comfort and convenience. In the rare life-or-death situation, time spent on the road can play a deciding role in the outcome.
“The Level 3 trauma center designation at the hospital has been huge,” Fidler said.
The designation provides emergency care for people who would otherwise have been on a flight to Denver or Grand Junction. And with the addition of Telestroke technology, specialists are able to rule out strokes to prevent unnecessary transportation. From its implementation in the hospital’s emergency department in November 2018, 123 patients have benefited from the technology.
Patients who had even a sign of stroke were often previously flown out, she said. But now, the quick access to a neurologist can provide an immediate, and more thorough, assessment.
On the flip side, people with special care needs, such as oncology, cardiology and chronic pain management, often choose where to live based on the services available within the area.
What: The 2020 Longevity Project Speaker Event
Speaker: Sean Swarner, longtime adventurer and first cancer survivor to summit Mount Everest
When: 6 p.m. Sept. 30
AND ALSO …
What: The 2020 Longevity Project local panel on living well in the Colorado mountains
Panel: U.S. Ski Team racer Alice Mckennis from Glenwood Springs; Navy SpecOps veteran and cancer survivor Dash Doung Wong of Aspen; U.S. Paralympic racer Noah Elliott of Steamboat Springs; visually and hearing impaired reporter/documentarian Nick Isenberg of Carbondale
When: 4 p.m. Sept. 29
Tickets: Free for both events with advanced registration at SteamboatPilot.com/longevity
Fidler also observes travel time and ease of access can make the difference between patients getting non-emergent care and neglecting it.
Working to keep more patients in Steamboat — a more geographically remote location — is also enticing some to stay close to home instead of traveling to the Eagle or Roaring Fork valleys.
Many of Colorado’s recent leaps and strides toward better, more accessible health care were facilitated in part by the state’s expansion of Medicaid under the Affordable Care Act in 2013, said Cara Welch, the Colorado Hospital Association director of communications.
At Yampa Valley Medical Center, growth was already well underway, but the merger of the hospital in 2017 into the UCHealth network led to a more rapid expansion of offerings — from the opening of the endocrinology and ear nose and throat clinics, in 2018 and 2019 respectively, to the 2020 addition of a midwifery program in the UCHealth Women’s Care Clinic and the opening of a full-time neurology clinic and rheumatology clinic just in recent weeks.
The merger, referred by some community members as more of a takeover, was not without challenges. There was strong sentiment against the move from both hospital staff and community members over concerns of what a corporate union would do to the independent community hospital.
Several years later, it is unlikely all discontent has disappeared, but Fidler said on the recent marking of the three-year anniversary, the decision to seek out and choose a partnering organization has only been solidified.
Not only by the list of accomplishments, she said, but also in the past six months going through the unprecedented experience of a global pandemic.
“There is a lot of pride in our workforce and community in being associated with UCHealth,” Fidler said.
On the merger, UCHealth Communications Specialist Lindsey Reznicek added the move was made proactively to ensure the community maintained access to high quality care.
While there are rural hospitals struggling and closing in many parts of the country, a rural hospital has not closed in Colorado since the 1980s, according to the hospital association’s data.
Reznicek said the timing of the merger was important to ensure the hospital in Steamboat had control of the decision and was an attractive partner. Fidler also pointed to the importance of making sure the values and mission were aligned between the two organizations.
Another expansion not without strife was the partnership with local orthopedic surgeons to open the new ambulatory surgery center. The negotiations took years and began with significant disagreement between hospital administrators, the community and the surgeons. Ultimately, the voices of the surgeons and community were elevated, and the process became much more amiable.
Of course, all of this expansion costs money, and that takes careful planning, Fidler said.
“There is a certain profit margin we need to achieve,” she explained. “We have to ask: ‘What do we need to reinvest back into the community, and what do we need to reinvest back into our facility’s growth and strategic planning?’”
At this time, cancer patients still have to travel for radiation and oncology treatments. Fidler said they are closely monitoring demand and need for that service and are planning for how to fund an addition when the numbers dictate enough business to make the investment sustainable.
November 1999: Yampa Valley Medical Center opens in its current location with expanded services.
2008-2009: Expansion and renovation of departments, including Family Birth Center and Special Care Nursery, and surgical services.
2012: Simulation lab opens.
2014: Gloria Gossard Breast Care Center opens; robotic surgery begins.
2017: Jan Bishop Cancer Center opens.
Sept. 1, 2017: Yampa Valley Medical Center joins the UCHealth system, becoming UCHealth Yampa Valley Medical Center.
2018: Behavioral health rooms open in the emergency department; Level III trauma center designation; implementation of Epic as the hospital’s electronic medical record; UCHealth Endocrinology Clinic opens; five-year, $1.375 million commitment, in partnership with Craig-Scheckman Family Foundation, to support mental and behavioral health resources in Routt County schools; automated breast ultrasound now available at UCHealth Gloria Gossard Breast Care Center; Telestroke now available; 10-year, $1 million partnership with Old Town Hot Springs focused on wellness for people of all ages.
2019: UCHealth Ear, Nose and Throat Clinic opens; pediatric cardiology and neonatal nurse practitioner partnerships with Children’s Hospital Colorado; mobile PET/CTs available; partnership with Steamboat Resort, focusing on health and wellness.
2020: Midwifery program begins at UCHealth Women’s Care Clinics in Steamboat Springs and Craig; Community Health Benefit Fund awards $275,000 in grants to 14 nonprofits; plastic and reconstructive surgery, with a focus on breast reconstruction, begins; UCHealth Neurology Clinic opens full time; UCHealth Rheumatology Clinic opens; Steamboat Surgery Center opens.
Courtesy of UCHealth Yampa Valley Medical Center
The UCHealth merger gave a big infusion of cash — with about $105 million in profit for the local hospital. From that, former CEO Frank May said in 2018 about $50 million went into strategic capital, $20 into the Yampa Valley Health Care Foundation and $35 million in IT integration and routine capital.
Fidler said philanthropy also plays a significant role. In 2012, for example, the simulation lab opened, thanks to the generosity of a donor. In the lab, “physicians and staff are able to practice high acuity, low frequency care protocols, ensuring they’re ready for whatever patient need may arise,” Reznicek described.
In terms of the concept of “access to care,” Fidler noted that it has a broad definition. It can be something basic like transportation, or a much bigger barrier, especially in the high country, of cost. In Colorado, the mountain areas have the highest rates for insurance premiums in the state.
Fidler said the hospital is constantly working to reach more underserved populations, and it is very aware of the need for more local resources in the area of mental and behavioral health care.
Fidler noted the importance of the community health needs assessment, which takes place every three years, on informing decision-making on where to make investments. The assessment takes a deep dive into the data and involves a survey of the community and health professions.
“It sets the base on how we decide what the community needs,” Fidler said.
That also translates to investment priorities outside the hospital.
In June, Yampa Valley Medical Center Foundation awarded 14 nonprofits a total of $275,000 in grants from the Community Health Benefit Fund. The grant aligned with the funding priorities of access to health care, mental health and substance use disorder.
Keeping Colorado’s rural hospitals open is one of the best ways to ensure residents maintain a high level of access to care, Welch said.
Welch said community support and strong hospital leadership also played major roles in keeping Colorado’s hospitals open.
“Collaboration of our hospitals as a system is another factor,” Welch explained. “At times, they may compete for some business, but they collaborate in a number of ways that benefits all the hospitals throughout the state.”
Reznicek noted Yampa Valley Medical Center has been able to share best practices with bigger hospitals, while also benefitting from the experience and expertise of others.
“A lot of the higher acuity specialty care does still tend to come to the Denver metro area,” Welch said. “But, all our hospitals have really focused on what services they need to provide their communities, so people don’t have to travel as far.”
Glenwood Post Independent reporter Ike Fredregill contributed to this article.
To reach Kari Dequine Harden, call 970-871-4205, email kharden@SteamboatPilot.com or follow her on Twitter @kariharden.
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Peak Health Alliance, a health care purchasing cooperative created in Summit County in 2018 after it had one of the highest average health care costs in the nation, is looking to expand to Routt County.