Whole Health, LLC

Supporting Repeat Emergency Room Users

Whole Health, LLCWhole Health, LLC’s primary goals all fit within realm of the Triple Aim, which involves the three key goals of improved individual health care, improved population health and lowered health care costs. Repeat emergency room visits can be costly and disruptive to patients, providers, and community members.

Whole Health, LLC is a subsidiary of Mind Springs Health, Inc., and was created to support repeat emergency room users. Whole Health, LLC supports this vision with the implementation of the Community Health Worker Program (CHW). Community Health Workers identify potential patients who need help and work with them to modifying their behaviors to reduce unnecessary visits and hospitalizations

The Community Health Workers

Whole Health, LLC’s Community Health Workers are highly motivated individuals trained to help others reach their health goals while connecting them with the best community resources and reducing ER visits in the process. They engage with patients in health behavior change and connect them with medical, behavioral, and social services needed to improve quality health and wellness in the community. CHWs facilitate patient access to these services through a variety of outreach activities including community education, informal mentoring and social support. CHWs enhance communications with primary care physicians, serving as a vital link between patients and providers to ensure enduring collaborative partnerships.

The Patients

Potential patients for the CHW program are selected based on claims data that participating medical providers receive from Rocky Mountain Health Plans (RMHP). Repeat emergency room users are identified and invited to attend a meeting with both a provider and a CHW present to introduce the program’s aims. If the patient chooses to participate, the CHW will then follow up with the patient to conduct a wellness assessment, identify health goals, and develop plans for achieving those goals.

A Typical Meeting

CHWs schedule meetings in the locations where patients feel most safe, whether that’s at home, in a coffee shop or at the grocery store. The frequency, type and location of meetings is based on the patient’s individual needs, and CHWs can assist patients in any or all of the following activities, among others:

Program Locations

The Community Health Worker program is currently offered in Colorado’s Mesa, Montrose, Garfield and Pitkin counties. The following medical practices are able to use this service:

Mesa
Foresight Family Physicians; Primary Care Partners; St. Mary’s Residency; coming soon: Juniper Family Practice

Montrose
Montrose Medicine; Pavilion Family Practice; The Practice of Lars Stangebye, MD; The Practice of Miller, MD & Peterson, MD; San Juan Family Medical

Garfield-Pitkin
Mountain Family Health Centers (offices in Rifle, Basalt, Glenwood Springs); MidValley Family Practice

Additionally, one CHW is assigned to Rocky Mountain Health Plans to work with unattributed members, helping them find primary care physicians and offering support in their pursuit of improved health.

Future Directions
Whole Health, LLC continually evaluates the necessity for additional programming. Criteria for program admission may be expanded based upon partner, patient, and community needs. Additionally, Whole Health is working with the Valley Health Alliance (VHA) in Aspen to hire and deploy a Health Coach to their employers.

Contact Whole Health, LLC

Amy C. Gallagher, Psy.D.
Vice President
Whole Health, LLC
Office: 970-683-7078
agallagher@WholeHealthManagement.org

Programs, Partnerships and Resources

Mind Springs Health provides several resources for those struggling with a mental illness or substance addiction beyond Whole Health, LLC. We believe local community has a profound opportunity to support those with mental illness and help them thrive. Check out our complete guide of partnerships and programs to see how we’re working to impact our local community.