Over a decade ago, CCMU staff went on a grand tour of Colorado to meet with community residents and health care leaders. After the completion of the Healthy Colorado Now! Tour, CCMU had convened over 40 town hall meetings and met with hundreds of Coloradans across the state. Although we haven’t undertaken a trip quite as ambitious since that tour, we’ve continued to work with local community leaders across the state.
As part of our 15 year celebration, we decided it was time to again make a concerted effort and travel to the far reaches of our great state to meet with health care leaders and community members to gauge current work, rekindle old relationships, and get a feel for where health care in Colorado is headed. And so last week, I loaded up my car and hit the road for a weeklong jaunt across much of the state. All told, I’ll travel over 1,100 miles from the northeast to the southwest. I have quite the agenda in place, and am looking forward to meeting with some of our state’s best and brightest minds in the health care world. Check back to this post every day this week for an updated account of what I’m learning!
TOUR STOP 1: STERLING, CO
When I walked into the Village Inn in Sterling, CO late this past Thursday afternoon, I was immediately reminded of my childhood. You see, as I explained to the colleague I was meeting; I’m a Village Inn baby. My parents met over 40 years ago as sophomores at Thomas Jefferson High School while working at a Village Inn in Southeast Denver. Needless to say, I ate many a Village Inn pie growing up. When I arrived in Sterling I knew I’d have a pleasant meeting, not only because my meeting was in a Village Inn, but because I know firsthand how welcoming and hospitable folks who live on the Plains are.
My meeting was with Jackie Reynolds, Executive Director of Rural Solutions. Based in Sterling, but covering 10 northeast Colorado counties, Rural Solutions has been “creating positive solutions for the health and well-being of [their] diverse communities” since 1994. The coalition fulfills their mission through coordinating behavioral and mental health programs, helping residents rise out of inter-generational poverty, conducting community health education, and facilitating a robust speaker’s bureau focusing on current health care changes.
When our conversation turned toward the current state of our nation’s health care system, we both wondered: “In the face of all these challenges, what gives us hope?” We both agreed that, after seeing firsthand all the amazing health care systems work happening on a local level in communities across the state, something big is happening here. A groundswell of change is occurring in Colorado, regardless of what the future holds on a national level. Coalitions like Rural Solutions—and others I’ll meet throughout my statewide tour—are piloting groundbreaking, über-local innovations in care coordination, community health navigation, and access to health care. All of this work is creating a real culture change around community health in pockets across the state.
Taken as a whole, this local work is truly incredible. At CCMU, we’re committed to supporting local health care system transformation with the ultimate goal of empowering communities and engaging citizens. To this end, we’ve recently launched the Colorado Network of Health Alliances, which brings together over 15 health alliances, like Rural Solutions, to pool resources, share best practices and lessons learned, and build collective power to make a real difference in Colorado health care system. We’re excited about this work and will provide more details as our tour continues. Stay tuned!
TOUR STOP 2: EVANS, CO
In my travels around Colorado, I’m often reminded of the old Haitian proverb: “Beyond mountains, there are mountains.” In literal terms, there are some parts of the state where there are literally mountains beyond mountains, however the Haitians use the proverb to express the idea that opportunities are inexhaustible, and at other times, to reflect that once you overcome one challenge, you simply gain a clearer view of the next one.
These seemingly dueling views of what lies next on the horizon lend themselves well to the current health care landscape. New innovative community-based solutions to health care systems change seem to be cropping up every day. Sometimes I wonder if the opportunities for meaningful change to our health care system are, in fact, inexhaustible. At the same time, I know that once communities overcome a daunting local health care challenge, there are still many hurdles ahead.
This past week I had the pleasure of learning about the opportunities and challenges facing the North Colorado Health Alliance. Based in Evans, CO, the alliance is a collaboration of partners “dedicated to cultivating the health” of the Northeast Colorado region. The alliance is implementing innovative care solutions like deploying Community Health Workers and community care teams in neighborhoods with the highest health and social needs. Early data show encouraging results that mirror the cost savings and quality of life improvements of similar “hot-spotting” projects in other parts of the country.
I've now headed to Southwest Colorado to learn about other exciting innovations taking place in La Plata County, and then I'll be moving on to Telluride where I'll undoubtedly learn more. Tonight, when reflecting on the amazing, collective movement of health care change happening in Colorado, I’m reminded by a quote from one of my heroes, Paul Hawken: “What I see are ordinary and some not-so-ordinary individuals willing to confront despair, power, and incalculable odds in an attempt to restore some semblance of grace, justice, and beauty to this world.”
TOUR STOP 3: DURANGO, CO
The La Plata County Citizens’ Health Advisory Council (CHAC) just adopted a new logo that highlights an aspen grove. The aspen grove is a metaphor for the nature of the coalition. In their words: “The CHAC, planted in the community, is like a mature aspen tree and the grove in which it thrives. From the root system, ideas are gathered and needs are recognized. Fresh growth from the roots expands to cover a hillside with new shoots. Limbs and leaves reach to the sky—like CHAC’s many projects which branch off into new directions, while others grow and become self-sustaining. The aspen grove is a healthy community of inter-connected yet distinct trees. The CHAC is part of a similar community, working toward a stronger, higher quality system of health and wellness for all.”
Driving through the southwestern Colorado mountains in the fall, the yellow aspen groves are omnipresent. The fall colors are at their peak right now and as I made my way to and from Durango, the trees were a constant reminder of the power of this metaphor. CCMU has been lucky enough to work with CHAC for over a year now. We’ve been traveling to La Plata County to record stories through our Colorado HealthStory project. Yesterday, I presented a number of these powerful stories at the 3rd annual La Plata County Health Summit, hosted by CHAC in Durango. Read the community profile (PDF) highlighting some of stories and listen to others here.
I left Durango with a renewed appreciation of CHAC’s leadership toward local health change in Colorado. Keynote speaker Dr. Jay Want, Chief Medical Officer at the Center for Improving Value in Health Care, echoed my sentiment in his closing remarks. “Real health care change will happen at the community level,” Dr. Want said, “and the Citizens’ Health Advisory Council is leading the way.”
TOUR STOP 4: TELLURIDE, CO
My meeting yesterday in Telluride with Lynn Borup, Executive Director of the Tri-County Health Network (TCHN), marked my last meeting on my statewide tour with an established Colorado health alliance. During our meeting, Lynn talked excitedly about TCHN’s efforts in care coordination, Community Health Worker deployment, and quality care improvement measures. Once again, I was struck by the close similarities between this alliance’s efforts and those of other health alliances around the state. When I explained the connection to Lynn, she was quick to point out that, yes, there are similarities, but TCHN is actually quite unique due to scale and geography.
TCHN represents only around 20,000 Coloradans who live in San Miguel, Ouray, and western Montrose Counties. Compare this to, say, the 350,000 people living in Aurora, CO and you can clearly see how TCHN’s focus would differ from that of Aurora Health Access. Lynn also explained how providers in urban cities, and even bigger rural cities like Grand Junction, have access to high-tech medical procedures that aren’t an option for providers in her network. In today’s health care landscape, nearly all of the players are interested in one thing above all others: driving down health care costs. With neither a large population of costly patients nor expensive medical procedures to eliminate, they must find new areas of significant cost savings to tap.
Instead of shying away from these challenges, TCHN’s goal is to provide a model health care system that can be applied in other rural areas. The network has begun to connect isolated private practices to one another to bring a population health approach to the region. They’ve hired local community members as Community Health Workers and Patient Navigators and offered their services in case management and health promotion to these practices. They’ve also convinced many providers to transition to electronic medical records, even without the assurance of cost savings, simply because the switch provides opportunities to provide higher quality and better coordinated care. And it’s working. In two short years, TCHN is seeing better health outcomes, higher quality care, and an improved culture of health in their communities.
Despite the differences in scale and geography, Lynn and I agreed that her network can both learn from and teach other health alliances throughout the state. That’s why CCMU recently launched the Colorado Network of Health Alliances. Bringing together over a dozen local health alliances from all over the state, this network will serve as a place of learning, networking, and innovative thinking. Just like TCHN brings together isolated providers, CCMU’s statewide network connects community health alliances that often feel like islands unto themselves. Through this statewide network, we’re excited to be a part of the burgeoning local health care change movement in Colorado and privileged to get to work with boots on the ground like Lynn Borup and the Tri-County Health Network.
TOUR STOP 5: SALIDA, CO
Yesterday I met with community leaders in Salida, CO. It was the first community I visited on my tour that didn’t have an established health coalition of some sort. Make no mistake, the need is there. All three of the health care leaders I met with dreamed of bringing all of the health care players in their community together to coordinate efforts and develop a shared vision of health in the greater Salida area. After telling them a bit about a few health alliances across the state, I assured them that their dream could certainly become reality. I have a feeling I’ll be back in Salida soon, this time meeting with a new coalition of community residents, providers, and health care leaders working together to improve their local health care system.
You would think after traveling 1,100 miles across much of the 8th largest state in the nation in just 7 short days, I’d be burned out and ready for a break. On the contrary, the 2012 CCMU Statewide Tour has left me inspired and energized to continue our great work of connecting and supporting local health systems change initiatives across Colorado. Tomorrow, I leave for Los Angeles to attend the Communities Joined in Action Annual Conference where I’ll learn the newest innovations and best practices from community health collaboratives across the country. I’ll bring these new skills back to Colorado to continue the movement toward local health systems that meet the needs of all residents in our state.
I look forward to my next tour of the state, which will hopefully take me to the southeast and northwest parts of Colorado. Do you know of a group of local health care leaders working together to make change in a Colorado community? Please let me know about them and I’ll be sure to add them to the next agenda!