Hospitals take wait-and-see approach to distribution of $205 million

The state of Wyoming is poised to receive more than $205 million this year as a result of the Rural Healthcare Transformation Program signed into law last summer.

On a per capita basis, the state’s share of $349 per person is second highest in the nation, behind only Alaska.  

But how much of that eventually benefits small, critical access hospitals like Three Rivers Health between Greybull and Basin remains to be seen.

Joel Jackson, CEO of TRH, said hospital officials around the state met with the Department of Health and Human Services (HHS) in mid-January.

“As best I can lay out, the stat’s going to send a response to CMS, CMS will respond back, then that information will be transmitted to the state legislature which would need to approve it,” he said.

Jackson said the upcoming session will be crucial and that he and other hospital officials are nervous but cautiously optimistic about how it will play out.

“Whenever the legislators get involved, I don’t want to say all bets are off, but a lot of different things could happen,” he said.

The Wyoming Department of Health’s application defined four primary goals: 1) increasing sustainable access to right-sized and coordinated rural medical care; 2) building a durable healthcare workforce pipeline; 3) improving metabolic, cardiovascular and behavioral outcomes and, 4) using technology and payment models to improve chronic disease management and bring care closer to home.

Jackson said 75% of the funding is intended to address the first two on that list. “What HHS has proposed is that those funds be set aside and encumbered in a trust fund where they’d grow each year,” he said. “At the end of five years, that fund would throw off $28 million to $34 million a year to support three elements in rural health.”

They include improving the availability of ground ambulance services, the viability of small, rural hospitals and access to labor and delivery services.

“Depending upon if your hospital has those three elements — we have one of the three — that’s going to have some impact on how much is available in a given year.”

Jackson said the trust fund concept “makes sense in the long term.”

“HHS was very clear that they didn’t want to write it out, as they know a lot of things can and will change over the next three months,” Jackson said. “For that reason, I would not expect clarity from the legislature or from DHHS until the end of April, maybe the beginning of May.”

The distribution of the remaining 25% of the funding would be more competitive, he said. Among other things, it deals with using technology to improve chronic care management and bring care close to home.

“As an example — and I’m not saying this is what would happen — North Big Horn and South Big Horn could work together to develop a better chronic pain management plan,” Jackson said, adding that the state would likely view it favorably because “it wants people working together to solve these problems.”

Jackson said if he has a concern, it’s that the state or county use this new funding as justification to cut some of their funding.

“The reality is, we don’t know what we’ll receive,” he said. “If we do receive funds, it’ll likely be for very specific purposes, so in essence, we’ll have our hands tied about how we use it.

“I don’t believe we’ll get nothing, but I don’t want to plan on receiving a lot. If we do receive support, it’ll be to support and improve services we’re already providing.”

Other hospital news

In other news coming out of the Jan. 21 meeting of the Three Rivers Health board of directors:

• The board opted to keep the status quo for its leadership posts, re-election Jeff Petty chair, Fred Werner vice-chair and Janet Evans treasurer.

• Staff is exploring the
possibility of converting its operating room space into a place where patients can receive infusions. Timing will be driven by demand and staffing, but the hope is to begin offering the service around July 1.

“Every time we do an infusion, we save someone two hours in a car,” said Jackson.

• Kelsey Sullivan, director of clinic and ancillary services, presented the findings of a community health needs assessment done in partnership with North Big Horn Hospital. Eric Connell and Payton Gamble attending the meeting as representatives of that facility.