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CCH prepares for new emergency department, hospitalist program management

Leadership says existing staff to be offered new employment contracts 

GILLETTE, Wyo. – An agreement to contract out management of the emergency department and hospitalist program at Campbell County Health does not expressly mean anyone is out of a job, hospital leadership says.  

Starting Jan. 1, emergency department and hospitalist staffing needs at CCH will be handled by Aligned Providers Wyoming. This local, provider-owned group currently serves 11 healthcare programs in Wyoming and Nebraska, according to an APW statement on the agreement. 

“All emergency and hospitalist physicians on staff will be offered contracts by APW to continue their employment at CCH at their current pay rate,” the statement reads. 

Matt Shahan, CCH’s chief executive officer, said APW approached CCH in the fall of 2021 about a possible agreement after years of negotiations failed to produce an agreeable employment contract between CCH, hospitalists, and emergency department doctors. 

“I know at that time they started talking, internally within the administration, that if we can’t get this contract negotiation worked out, then there is this other option,” Shahan told County 17 earlier this month. 

Staffing model changes

With APW taking over the management of CCH’s emergency department and hospitalist program, the staffing model for both will take on a different look, per Shahan. 

According to the APW statement, the organization relies heavily on nurse practitioners and physician assistants–also referred to as advanced practice providers– in the emergency departments it manages and on inpatient floors. 

“It’s probably a different staffing model than what people are used to,” Shahan said, adding that APW staffing methods align more with industry and national standards. 

Those standards, according to APW, reduce patient wait times while increasing access to emergency and critical care services. 

“At the four emergency departments where APW currently employs this model, integration of (advanced practice providers) helps ensure patients receive the highest level of care possible, expands programs in a financially sustainable manner, and helps combat recruiting challenges in strained healthcare staffing environments,” APW says. 

Shahan says the APW model at CCH would allow the hospital to better triage incoming patients and would be able to assign lower acuity patients to physician assistants and nurse practitioners, both of whom would be highly trained, rather than a physician. 

“One of the biggest advantages is that it’s going to allow our physicians to focus more time on those serious patients without feeling like they have to rush down the hall to check on somebody,” Shahan said. 

All advanced practice providers at APW will be required to go through a 6-12 month intensive internship program, similar to a residency for physicians, that will ensure they are well-trained in emergency and hospital medicine, per the statement. 


In response to a question asking for his take on statements by CCH physicians claiming to have been blindsided by the APW agreement announcement, Shahan said that he understands how they could feel that way. 

“But all in all, with the many years of contract negotiations that were going on, I think most of them had been a part of those and knew, at least on the other side, that was trying to be worked on,” Shahan said, adding that he made an effort to visit with as many doctors as possible starting on Sept. 16  about the APW agreement as soon as it was finalized. 

Notifying them prior to that date was not possible, given the nature of contract negotiations with APW and whether it was going to work out, Shahan said.