Annual Report 2015 - Axis Health System

Annual Report2015

2 Axis Health System Annual Report 2015

A MESSAGE FROM BOARD PRESIDENT JOHN ALBRIGHT

Looking at the last several years, the change, and growth at Axis Health System has been both dramatic and dynamic. In the last six months, we have secured federal funding for a Community Health Center in Cortez and have taken steps to expand our presence in Archuleta County. The decision to grow in these areas is no small thing and stretches our organizational and personal capacities. This brings increased pressure to everyone associated with Axis Health. So why do we do this? The simple answer is the need is great and the opportunity presents itself. We are also fierce in our determination to continually raise the bar and deliver better healthcare services to all.

The courage to stand up and act on a vision is a powerful force. A strength of our organization is the ability to carry that vision to fruition. We see ourselves as a valuable community resource and, as such, have a strong commitment to deliver quality care where needed. This thread is strong from our Board of Directors, CEO, and on through management and staff. The support we provide each other at Axis Health is a key ingredient to the success of our organization and this commitment translates directly to providing the best possible healthcare to our patients. Results continue to confirm that the whole person integrated care model that we have embraced is the best possible choice for a healthy life and outcome.

Lastly, it is a privilege to live and serve in this community and we will continually be alert and receptive to ways to improve the quality of care we deliver to residents in our region.

Reflections from leadership

“The courage to stand up and act on a vision is a powerful force. A strength of our organization is the ability to carry that vision to fruition.”

—John AlbrightPresident of the Board

axishealthsystem.org 3

Reflections from

leadershipThis past year has seen extraordinary growth of Axis and progress in our transition to an integrated, whole person healthcare system. In last year’s report, I noted our application to Health Resources and Services Administration (HRSA) to establish Cortez Integrated Healthcare (CIH) as a Community Health Center (FQHC). We were successful in that application and again, due to the efforts of Shelly Burke (COO) and Pam Wise Romero (CCO), had one of the highest scores in the country. The establishment of CIH as a Community Health Center gives Montezuma County a primary care resource for our un- and under-insured residents and provides an additional primary care resource for residents on Medicare and Medicaid.

Last year, with a major grant from the Colorado Department of Human Services, we expanded our behavioral health crisis services with the establishment of a mobile crisis team. Unique in the state (though now being copied in most of the other regions) we established mobile crisis 2-person teams that combined a behavioral health professional and an EMT. These teams have not only improved our ability to respond to behavioral health crises in the community, but have provided a much needed transport resource.

With the state Medicaid expansion, the second HRSA grant and the Crisis Response grant, Axis has grown 72.9% over the last 3 years. This growth has significantly expanded our capacity to care for the health of our residents in southwest Colorado, and it has also required significant additional administrative support (for program management and to respond to the reporting requirements that come with the services). This has led us to badly outgrow our administrative offices in Durango. As a consequence, we have purchased what was known as the Threadworks building in Bodo Industrial Park. In early 2016, we will be moving our entire administrative operation to that building and expanding our clinical care into the vacated space at our current site at 281 Sawyer Drive in Bodo. This organizational growth has resulted in more than 30 new positions and also required us to re-organize our administrative operation. Please be patient with us as we adjust to the new structures we have put in place.

With fully integrated, whole-person healthcare available in Montezuma and La Plata Counties, we are now poised for the next phase of our transformation with the establishment of care integration in Archuleta County. I am particularly excited to report that we are just beginning plans for construction of a new facility in Archuleta County. We hope to have that facility close to complete by the next annual report.

These are truly exciting times and our ability to take advantage of the opportunities the times present and better serve our communities is due in no small part to our incredible Board of Directors and staff. This past year, Kim Welty and Don Volger stepped off the Board and Karen Sheek and Matt Dodson have joined the Board which remains vibrant and committed to our mission.

My deepest gratitude goes to our Board of Directors, our management team and our incredible staff for their hard work this past year.

“...our ability to take advantage of the opportunities the times present and better serve our communities is due in no small part to our incredible Board of Directors and staff.”

A MESSAGE FROM CEO BERN HEATH

—Bern Heath Jr., Ph.D.Chief Executive Officer


Teamwork

John AlbrightPRESIDENT OF THE BOARD

Durango

Bill WarrenVICE PRESIDENT

Durango

Sarada LeavenworthSECRETARY

Bayfield

Chuck ForthTREASURER

Cortez

Matt DodsonPagosa Springs

Karen SheekCortez

Liane JollonDurango

Berenice LozanoDurango

Bob Juskevich, MDDurango

EXECUTIVE TEAM

Bern Heath Jr., Ph.D.CHIEF EXECUTIVE OFFICER

Shelly BurkeCHIEF OPERATING OFFICER

Pam Wise Romero, Ph.D.CHIEF CLINICAL OFFICER

OUR MISSION

Axis Health System will make a meaningful difference in the health of southwest Colorado residents by integrating all aspects of healthcare and treating the whole person.

BOARD OF DIRECTORS


Aaron Belson Alan Shaw Alexander Beardsley Alfredo Chavarria Allison Kain Amber Cibrian Amber Cox Amber Hutchins Amy Blaine Andrea Senti Angel Tracy Angela Romero Ann Mortenson Anna Simpson Annabel Asp Ashley Spishock Ashley Wagle Astra Ferris Barbara Robinson Bernard Heath Jr. Brad Roy Brandon Eubanks Brian Arens Brian Ensign Bridget Averill Brittney Sanchez Carla McCall Carol Parsons Carolyn Brown Carrie Martinez Carrie Slifka Casie LaMunyon Catherine Morrison Challis Gottman Chaondra Rochelle Charlene Lundberg Charles Albright Jr. Charles Southcotte Chelsey Kitts Cheryl Marable Cheryl Ryser Christian Sanders Christie Ilg-Salter Christine Wright Christopher Ziegler Cindy Woehrel Connie Robb Courtney Dickinson Cynthia Swanson Cynthia Trautmann Cynthia Whitney Dana Hoffman

Daniel Thomas Danielle Parker Darianna Sparks Darlene Clayton David Awdish David Long Dawn Archuleta Deana Carr Deborah White Debra Quayle Della Pope Dominique Poumirou Donald Mooney Dustin Scholfield Elizabeth Davis Elizabeth McCleary Elizabeth Pusateri Ellen Stein Ellen Wassif Emily Campbell Erik Foss Erin Brach Erin Harris Erin Linden Erin Lowry Erin McGrath Eve Williams Felicia Folsom Frederick Colson III Genevieve Travis Gordon South Harry Roanhorse Hillary Wolfe Jamie Curtis Jamie Denier Jeffrey King Jennie Jenkins Jennifer Bearden Jennifer Berkman Jennifer Calderwood Jennifer Crozier Jennifer Johnson Jennifer Shupe Jennifer Stucka Jeremiah Scott Jerrold Fields Jessaca Cassady Jessica Fucito Jessica Rice Jessica Wheatley Joanna Smith John Canning

John Kabosky John Rowe John Shaddock Jonathan Lewis Jordan Wildman Joy Morris Julie Frank Julie Lewis June Worthington Kari Bumpus Katherine Holt Kathleen McCormick Katie Garlick Katrina Lennex Kayce Gallegos Kerri Orr Kevin Linville Kim Jacques Kimberly Morris Kristen Hale Kristen Ray Kristen Roessler Kristi Nelson Kristin Kozak Kristin Markley Kristyn Eller Lara Ristow Laura Agurkis Laura Milke Laura Moore Lauren Smith LeAnn Shaw Leigh Parker Linda Cook Linda Lute Lindsay Stonecash Lindsey Mietchen Lisa Fischer Lizeth Pardo-Zubiate Lori Raney Lurenda Evans Mackenzie Dixon Malissa Davis Manda Sloan Marcia Newth Margaret Blackmer Margaret Kaems Marguerite Gallagher Maria Vaughn Marjorie Cristol Mark Caldwell Martin Stewart

Matthew Powell Megan McDaugale Megan Murphy Megan Roundy Melanee Hodge Melanie Vigil Melisa Dillon Melodi Gallegos Michael Brieger Michael Glade Michael Gostlin Michellerenee Hanson Molly Rodriguez Nancy Johnson Nicholas Beveridge Nija Gilman Norman Roundy Pamela Martinez Pamela Wise-Romero Patricia Nelson Patricia Roy Patricia Supanich Patricia Wilson Patti Snodgrass Paul Rathbun Paula Denson-Tower Pauline Beaver Peggy Bayless Peter Dybing Rebecca Skelton Rebecca Voymas Renee Averill Richard Cooper Richard Jacobsen Robert Medearis Robin Chavez Roxann Stettler Russelyn Connor Rustin Bartel Ruth Uhl Ryan Elliott Ryan Shepherd Samantha Nez Samantha Sanford Samuel Verutti Sandra Cramer Sarah Dougherty Scott Brandstetter Sean Evans Shane McManamon Shanna Stordahl Shannon Ferrari

Teamwork

DIRECTORS

Stephanie Allred, Ph.D.Senior Director of Clinical Services

Erin HarrisDirector ofAdministrative Services

Victor Lopez, MDMedical Director

Lori Raney, MDDirector of Psychiatry

Patricia Roy, SPHRDirector of Human Resources

Chuck SouthcotteSenior Director ofInformation Technology

Ellen SteinDirector of Development

Patricia SupanichDirector ofQuality/Compliance

Debbie WhiteSenior Director ofFinancial Services

STAFF

Sheena Kline Shelley Millsap Shelly Burke Sherry Bundrant Sherry Ketner Stacy Reuille-Dupont Stephanie Allred Stephanie Sears Stephen Lewis Steve Kitson Susan Etter Susan Grayson-Moore Susan Morris Susan Leigh Meigs Syl Manlove Tanner Zellitti Tara Jackson Tava Wilson Tawnya Jacobson Taylor LaRocco Terry Brown Tharakesh Palanisamy Thomas Bonde Timothy Schaldach Timothy Stettler Tina Elliott Tommy Montoya Ty Calderwood Vanessa Mytko Vicki Vacanti Victor Lopez Victoria Funner Wendy Gurule Wendy Sickich Whitney Pack William Fine William McKeon William Shanahan Yvonne Castellano


Patient SatisfactionSurvey Results

A unifying principle of healthcare reform is Berwick, Nolan and Whittington’s Triple Aim which states that to successfully reform healthcare we must: 1. Improve the experience of care, 2. Improve health outcomes, and 3. Reduce per capita cost.

We have found that improving the experience of care engages patients better and more effectively in their own health, leading to improved health outcomes, in turn resulting in a reduction of the overall cost of our healthcare system. This is why patient satisfaction is so important to Axis Health System and why we use two different systems to measure our patients’ satisfaction with care.

The first system measures satisfaction at a visit level. At our two integrated health clinics, Cortez Integrated Healthcare and La Plata Integrated Healthcare, we have instituted a simple, one-question questionnaire following each visit to gauge satisfaction. It takes only 15 seconds to complete. In September of this year an astounding 96% of visits to our integrated clinics were rated “good” or “excellent”.

The second system measures overall satisfaction with services. Developed in 2008 and modified in December of 2014, this survey accommodates new elements of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) requirements as we integrate care delivery and use a consistent integration approach.

We collected 565 surveys across six locations. This is the largest sample ever collected providing a broader response to assess patient satisfaction in relationship to their experience of care.

Current patient satisfaction remained high with four of twelve questions scoring at 90% or better, seven questions scoring at 80% or better, and only one question scoring at 70%.

Greatest overall satisfaction continues to be reported in areas of staff professionalism and quality of services received. Areas for improvement were noted as improved appointment availability for immediate care and improved communication around patient wait time subsequent to check-in.

HIGHEST OVERALL SATISFACTION WAS REFLECTED IN THE FOLLOWING AFFIRMATIVE RESPONSE PERCENTAGES

97%felt their wait time to see their healthcare provider was reasonable

97%felt they were treated with dignity and respect by staff

92%felt their healthcare provider listened to thereasons for their visit

90%felt their healthcare provider encouraged them to ask questions and provided opportunities to participate in the development of their care plan


656

780

4,248

912

0 -‐ 11 Years

12 to 17 years

18 to 59 years

60 + years

Pa#ent Ages

Patient Data

3,383

3,213 Female

Male

Pa#ent Gender

Prepared by (JC/SQL)10/26/15

pa7ent and service data.xlsx

Pa#ent DemographicsFY 2015

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

ARCHULETA LA PLATA MONTEZUMA DOLORES SAN JUAN OTHER

444

3,641

1,575

380 159

397

ARCHULETA

LA PLATA

MONTEZUMA

DOLORES

SAN JUAN

OTHER

Pa#ents Served by County -‐ Total: 6,596

PATIENT AGES

0–11 years 12–17 years 18–59 years 60+ years

PATIENT GENDER

Female Male

PATIENTS SERVED BY COUNTYTotal 6,596

Archuleta La Plata Montezuma Dolores San Juan Other

4,248

912656

780

3,3833,213


Service Data

Prepared by (JC/SQL)10/26/15

FY2015_Annual_Report_PaAent and Service data.xlsx

Pa#ent HoursFY 2015

Archuleta La Plata* Montezuma* Other Colorado Out of State Total

36 675 119 11 6 847

8 90 20 1 3 122

121 1,873 226 79 281 2,580

19 654 82 36 115 906

*La Plata includes paAents from San Juan County and Montezuma includes Dolores County

ATU Number of Bed Days:

ATU Unduplicated PaAents:

Detox Number of Bed Days:

Detox Unduplicated PaAents:

ATU & Detox Bed Days by Loca#on

87%

7% 6%

Behavioral Health

Primary Care

Substance Use

Percent Pa#ent Hours for Archuleta County

44%

29%

8%

19%

Behavioral Health

Primary Care

School Based Health

Substance Use

Percent Pa#ent Hours for La Plata & San Juan Coun#es

42%

52%

0% 5%

Behavioral Health

Primary Care

School Based Health

Substance Use

Percent Pa#ent Hours for Montezuma & Dolores Coun#es

ATU & DETOX BED DAYS BY LOCATION

Co-‐Located Care 1%

Coordinated Care 3%

Pre-‐Coordinated Care 31%

FY 2014 Pa*ent Percentages by Level of Integra*on*

72%

25%

2%

1%

The Integrated Practice Assessment Tool and more information about Levels of Integration is available at www.ipats.org.

2015 PATIENT PERCENTAGES BY LEVEL OF INTEGRATION

Integrated Care Co-Located Care Coordinated Care Pre-Coordinated Care

PRE-COORDINATED

LEVEL 0Exchange of

Information Without Communication

COORDINATEDKEY ELEMENT: COMMUNICATION

CO-LOCATEDKEY ELEMENT: PHYSICAL PROXIMITY

INTEGRATEDKEY ELEMENT: PRACTICE CHANGE

LEVEL 1Minimal

Collaboration

LEVEL 2Basic Collaboration

at a Distance

LEVEL 3Basic Collaboration

Onsite

LEVEL 4Close CollaborationOnsite with Some

Systems Integration

LEVEL 5Close Collaboration

Approaching anIntegrated Practice

LEVEL 6Full Collaboration

in a Transformed / MergedIntegrated Practice


69.1%

10%

8.4%

4.6% 4.1% 3.8%

2015 Expenses

Private Insurance-FFSPublic InsuranceFederalStateLocal

Total

Personnel Other ExpensesOperatingClient CareOccupancyProfessional Fees

Totals

4.4%

51.7%

5.1%

21%

17.8%

2015 Revenue

69.1%

10%

8.4%

4.6% 4.1% 3.8%

2015 Expenses

Financial Overview

2015 REVENUE

Private Insurance - FFS Public Insurance Federal State Local

2015 EXPENSES

Personnel Other Expenses Operating Client Care Occupancy Professional Fees

The fiscal year 2015 annual independent audit of Axis Health System is available upon request.

4.4%17.8%

21%

5.1%

51.7%

3.8%4.1%

4.6%

8.4%

10%

69.1%


Grantsand Contributions

INTEGRATED CARE DEVELOPMENTAdvancing Care Together for care model innovations at Cortez Integrated Healthcare

Colorado Department of Public Health and Environment for operational support of the School-Based Integrated Healthcare clinics

The Colorado Health Foundation for operational support of Cortez Integrated Healthcare and School-Based Integrated Healthcare at Durango High and Florida Mesa Elementary Schools

Durango School District 9R for operational support of the School-Based Integrated Healthcare clinics

Sustaining Healthcare Across Integrated Primary Care for testing global budget models for integrated healthcare

CARE COORDINATIONFort Lyon for homeless substance use outreach and case management at La Plata Integrated Healthcare

Rocky Mountain Health Plan for development of a Community Health Worker program in La Plata and Montezuma counties

San Juan Basin Health for oral health coordination at La Plata Integrated Healthcare

COMMUNITY FUNDINGVarious specific program and access support provided by:

Towns/Cities: Bayfield, Cortez, Dove Creek, Durango, Ignacio, Mancos, Pagosa SpringsCounties: Dolores, La Plata, Montezuma, San Juan Other: Upper San Juan Health Services District

United Way: Various specific program and access support provided by United Way of SW Colorado in La Plata, Montezuma and Archuleta Counties.

Axis Health System is grateful for the financial

support it receives in support of essential

community programs.


Regional Mapof Locations

HEALTHCARE FACILITIES OPERATED BY AXIS HEALTH SYSTEM

1 Cortez Integrated Healthcare

2 La Plata Integrated Healthcare

3 Bodo Clinic at the Columbine Center

4 Crossroads at Grandview

5 School-Based Integrated Healthcare at Durango High School

6 School-Based Integrated Healthcare at Florida Mesa Elementary School

7 Pagosa Springs Clinic at the Adobe Building

OUR VALUES

Making a meaningful difference

Supporting family, joband intimate relationships

Engaging all consumers and family members

to the best of our ability

Patient and consumer partnership

Culture of change and intrapreneurship

Commitment to excellence

ADMINISTRATIVE OFFICES281 SAWYER DRIVE, SUITE 100 DURANGO, CO 81303

970.259.2162 PHONE | 970.247.5255 FAX

axishealthsystem.org

24 HOUR & CRISIS CARE 970.247.5245

ARCHULETA, LA PLATA, SAN JUAN,

DOLORES and MONTEZUMA COUNTIES

BODO CLINIC AT THE COLUMBINE CENTER281 SAWYER DRIVE, SUITE 100

DURANGO, CO 81303 970.259.2162

CROSSROADS AT GRANDVIEW1125 THREE SPRINGS BOULEVARD

DURANGO, CO 81301 970.403.0180

LA PLATA INTEGRATED HEALTHCARE1970 EAST 3RD AVENUE

DURANGO, CO 81301 970.335.2288

CORTEZ INTEGRATED HEALTHCARE 691 EAST EMPIRE STREET

CORTEZ, CO 81321 970.565.7946

PAGOSA SPRINGS CLINIC AT THE ADOBE BLDG475 LEWIS STREET PAGOSA SPRINGS, CO 81147

970.264.2104

SCHOOL-BASED INTEGRATED HEALTHCARE AT DURANGO HIGH SCHOOL

2390 MAIN AVENUE DURANGO, CO 81301 970.375.3832

SCHOOL-BASED INTEGRATED HEALTHCARE AT FLORIDA MESA ELEMENTARY SCHOOL

216 HIGHWAY 172 DURANGO, CO 81303 970.385.1168

Annual Report 2015 - Axis Health System

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