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Cheyenne Regional Medical Center faces many of the same challenges encountered by small and rural hospitals and care systems. Based in the state capital, the 220-bed health care system is the largest in Wyoming. About 20 percent of its patient population lacks health insurance, more than 20 percent smoke and more than 24 percent of the adults are obese.

While those statistics are daunting, Cheyenne Regional's board of trustees and senior leaders have successfully navigated the changing health care landscape by focusing on a mission aligned with the Triple Aim and partnering with community and state organizations to lead population health initiatives.

Board Drives Community Health

Chair Joe Evans has served on the board for three years and participated in several committees, including the community health and benefit committee. "Improving community health always has been one of the board's priorities," Evans says. The medical center also works to reduce the number of patients without health insurance who come to the emergency department because it is "the only place they can go," he explains. "Our emphasis is trying to reduce that by putting patients in clinics before they get so sick."

In 2005, Cheyenne Regional helped to create the Cheyenne Health and Wellness Center in South Cheyenne, the first federally qualified health center in Laramie County. The center serves more than 5,000 patients annually, and 70 percent have family incomes below 100 percent of the federal poverty level. Patients can receive general primary medical care, dental and vision services, flu shots and immunizations, diagnostic testing and screening, pregnancy testing and referral, well-child visits and more preventive health care services. According to former CEO John Lucas, M.D., who retired Sept. 1, "We are Triple Aim-oriented to improve outcomes, get maximum patient engagement and reduce the cost of care."

Partnering and Leading

Since 1995, the medical center has co-chaired Healthier Laramie County, a 65-member community collaborative. "We keep the group together and focused on health care," Evans says. He urges other hospitals to focus on investing in and nurturing community partnerships: "They provide a lot of benefit with a small amount of money and engage the community in sustainable initiatives."

As the largest hospital in the state, Cheyenne Regional also wanted "to move beyond Laramie County," Lucas says. "We have delivery system provider partners everywhere and a lot of grassroots activism," he notes. Grants from the Centers for Medicare & Medicaid Services have helped to fund initiatives, including a health care innovation award to transform care delivery across Wyoming. The hospital's leadership also points to partnerships with the Wyoming Hospital Association, Wyoming Department of Health and other state agencies.

Lucas and Evans offer guidance for managing population health:

  • Look at your mission statement and create will around delivering on the promise of better health, better care and lower cost.
  • Change organizational culture to support the mission of population health.
  • Avoid working in isolation. Look for opportunities to partner with national, state and local organizations to leverage resources.
  • Think about and redefine value and then harness internal and external resources accordingly.

Accomplishing these goals is "massively difficult and a major transformation for most people," Lucas observes. Cheyenne Regional is working to achieve small successes every day and sharing that knowledge with other organizations.

The Hospitals in Pursuit of Excellence guide, "The Role of Small and Rural Hospitals and Care Systems in Effective Population Health Partnerships," is available at

Cynthia Hedges Greising ( is a communications specialist at the Health Research & Educational Trust, Chicago.