The operation began with a few volunteers delivering medical care out of a vehicle. Today, under the leadership of CEO Pam McManus, Peak Vista Community Health Centers spans 26 locations serving nine counties. The nonprofit’s mission is to provide health, dental and integrated behavioral care to those with access barriers.
McManus began with Peak Vista, then El Pomar Community Health Center, in 1991. She spoke with the Business Journal this week about the region’s strengths and shortcomings when it comes to taking care of its most vulnerable neighbors.
Where are you from?
I’m a Colorado native. I’m from and grew up in Durango. My senior year of high school, my parents moved to Montrose, but after I graduated high school, I moved back to Durango and went to college at Fort Lewis, where I studied accounting. … After college I wanted to move to the big city. I was offered a job in Denver with Deloitte & Touche. At the time, I knew Denver would not have been what I considered home, but I wanted to go to a bigger city, so Colorado Springs was the perfect answer. I came here to work at Deloitte & Touche but always knew health care was where I wanted to end up. I worked a lot of odd jobs going through high school and college in health care because I wanted to learn as much as I could. When the position came open at Peak Vista (although it wasn’t Peak Vista then) I happily said yes. It’s been 26 years.
What health care jobs did you take while in school?
Everything. IT systems to ER tech to phlebotomist. Back then you could do more things without certifications. … I worked in the accounting department, the enrollment department; I was a ward clerk on the floor. Those were while working at Memorial Hospital in Montrose and Mercy Medical Center in Durango.
What about health care appealed to you?
Making a real difference both from the preventative side and the healing side. Truly, peoples lives are impacted by their health and to be in an industry that focuses on that is an incredible honor.
Why study accounting and not health care administration?
My mother asked me that all the time! It was the way I thought I could best serve in health care. It was really the leadership track I wanted to be a part of, but understanding where the numbers come from seemed to be a good stepping stone. That sounds like I had it really planned out, but I was blessed with numerous opportunities.
Did you ever think about going into medicine?
Yes, but I think it takes a very special person for that and my gifts weren’t in providing care. My gifts are in being able to support systems that allow for health care.
What position did you start in at Peak Vista?
I was the accounts payable payroll cash coordinator.
That’s one title?
I became CFO of a three-person finance department. Then I had some incredible opportunities here to include senior vice president of operations and finance, COO and then, six years ago, on June 1, was my first day as CEO.
Talk about your organization.
Peak Vista is a critical safety net provider. Our focus is on providing quality care. ‘Quality’ is the operative word, and I love that we’re accredited through national quality organizations. It’s that testimony that what we’re doing is right. …
We provide care for those facing access barriers. Access is much broader than people first think.
Access barriers can include geographic factors — being in a community where there isn’t a health care provider. It can be cultural and we have to recognize the difference someone may need in their health care. It can be financial. Access barriers can mean there are providers in the community but it’s not a good fit or that provider isn’t accepting their insurance or coverage.
What do your patient demographics look like?
The ethnicity of our patients pretty much mirrors our community except we have a few more minorities than in the general community. The age of our patients — I think this really surprises people — but 40 percent [of those we serve] are children. Seniors are also sometimes a surprise — 18 percent of a our patients are seniors. I think it’s a surprise because seniors are facing access barriers but their communities don’t necessarily know that.
How have challenges changed over time?
I think the workforce development issue is a bigger challenge today than when I first started. The shortage of not just physicians, but other providers and support staff has grown. That’s part of what I love about Peak Vista. We’ve identified a need and came up with innovative ways of addressing that.
We were, I believe, the largest community in the nation without a primary care residency program until we started one two years ago. We’re in our third year beginning July 1 and our first residents will finish next June. This is great because communities have identified that doctors tend to stay close to where they finish their residency versus medical school. And I really consider this residency a community residency because we’re being supported by specialists and the hospitals. It’s a community effort.
We also have our Advanced Nurse Practitioner Fellowship program. That’s something we started here. I think we were the first or second to be accredited nationally.
That program has five nurse practitioner graduates every year. They go through their fellowship and then are eligible to graduate out of that fellowship. We’re on our fourth class and Peak Vista’s retention rate has been 80 percent. Four out of five have stayed within Peak Vista.
How has uncertainty in health care impacted operations?
One of the things I’m most proud about our board is we’ve learned we can’t rely on the highs and lows of policy. We need to be stable for our patients no matter the policies. Board and staff take a very active role in understanding policy and its impact on us, and so we work hard to diversify our revenue to be sure were there to continue our services.
We have a lot of pilot studies and processes we go through to test systems before rolling out to other programs We have lots of conversations at the state and federal levels about funding opportunities out there.
How is our state as safety nets go?
I’m pretty excited about what Colorado does and I think it’s due to the individual communities. One, we participated in the Medicaid expansion. That really made a difference compared to states that chose not to.
There are also several state programs, like the Colorado Indigent Care Program. Legislators also stepped up when the [Children’s Health Insurance Program] was at risk and said they’d figure out how to make [funding] happen. It later passed, so they didn’t have to, but you could see their intent. There seems to be an understanding that the healthier the community, the more productive the community.
That’s at the state level, but I’m pleased with how the community participates in supporting health care and the health of its people. I do think there’s more need and we have to continue working towards better outcomes.
What’s the health of health care?
I think the Affordable Care Act was a step toward recognizing health care needed some adjustments. I think we’re still at a place that needs adjustments. … We still have individuals and families caught in situations where health insurance is too expensive and yet you have to have it. I think there are things we need to look at or as a nation or we’re not going to get healthier.
Locally, I think we’re making gains — UCCS bringing medical students here and focusing on workforce development, Pikes Peak Community College and its clinical support programs are a step in the right direction. I believe that both hospital systems are trying to be part of the solution. In general, I think we are taking steps in the right direction.