Community Health Center Changes A Foot

The Community Health Center of Central Wyoming landed its permit to rebuild and relocate in Casper, but changes to the health center don't end there. K2 Radios Karen Snyder spoke with CEO Dan Reiner about the future of the health center whose mission is to bring affordable care to those who need it.

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After a 10 year partnership, The University of Wyoming Family Residency Program will likely no longer play the same role in serving patients at the Community Health Center of Central Wyoming. That fact, coupled with changes to the way providers are compensated, has meant the loss of a number of doctors, nurses and assistants not comfortable with the changes. Health Center CEO, Dan Reiner, says the two entities exist in different regulatory worlds, and that, in part, has led to tension and disagreement.

"The Family Medicine Program requires their faculty and residents to do certain things in order to graduate. They need to see a certain number of patients.  They need to have a certain number of rotations with certain physicians in order to graduate. Whereas, the Community Health Center's purpose in life is not education, it's to put in place an affordable patient care program that addresses community needs."

A financial element is also at play. The University program, Reiner says, needs more dollars coming in from paying and insured patients to keep its program going. For the health center to play a role in addressing that, Reiner says, they would need to lower the amount of uncompensated care they offer. Doing that, he says, would mean not fulfilling their mission.

Another big difference, Reiner says, comes out of the health center's need to provide continuity of care for patients.

"The patient needs to see their doctor on an on-going regular basis, but if a resident is going through their rotation, he or she, patient, has difficulty seeing his or her doctor in a timely way."

Reiner says HRSA, or the Health Resources and Services Administration, has elevated all its account-abilities and, he says, with greater continuity they hope to meet those goals. In addition, the Health Center has restructured compensation. Providers are no longer paid a salary, but rather, compensated based on patients seen and outcomes of care. In light of all the changes, he says, they've had a number of providers leave. Recruitment, he says, is underway.

"We've got two more doctors starting here in the next 30 days. We've got two more starting in September. We have a number of, either, Nurse Practitioners or PA's starting as we speak. So we hope, with the transition, that we can do it as seamlessly as possible."

Negotiation with the University continues, and Reiner says, he remains optimistic that some form of partnership will continue.

"And so I have proposed to the University that, even with us being in two different buildings, we can have their residents rotate through our practices so they have enough patient experience."

The new facility for the Community Health Center of Central Wyoming is expected to break ground off of Blackmore Road this summer and be open for business by the fall of 2012.