As rural hospitals try to determine whether or not they'll be able to form accountable care organizations, hospitals throughout Wyoming are in the early stages of developing the Wyoming Integrated Care Network. So far, the Wyoming Hospital Association, the Wyoming Medical Center, and 13 other hospitals are involved in the project, which aims to transform the primary care delivery system throughout the state using the patient-centered medical home model.
According to Dan Perdue, president of the Wyoming Hospital Association, ACOs were the impetus for starting to develop the network.
"Originally, this group was loosely assembled as a result of the ACO component of the Affordable Care Act," he says. "In fact, a lot of hospitals got together in November of 2010 just to kind of lay the ground work for forming an ACO here in the state."
Like other rural states, though, Perdue says Wyoming fights "the tyranny of numbers." Many rural stakeholders worry that forming an ACO just wouldn't be practical based on their small populations, and Wyoming is no exception.
According to 2010 census data, Wyoming's total population is 563,626, and Perdue says estimates put the state's total number of Medicare beneficiaries at less than 100,000. Not only are the population numbers small, but Perdue says Wyoming faces an addition challenge of having many of its population centers on located on the borders with other states. As a result, Wyoming's patients often head to cities such as Denver, CO Rapid City, SD; Billings, MT; and Salt Lake City, UT for their healthcare.
"I think we're one of the few states in the country that has the out-migration problem that we do and the scarce population that we do," Perdue says. "A lot of our patients seek care outside the state."