When Chief Executive Officer Robert Vissers began working at Boulder Community Health just under a decade ago, he was tasked with guiding a transition.
The medical center at Broadway Street and Alpine Avenue, just north of Pearl Street Mall in Boulder, had long been considered the main hospital within the now century-old community hospital system.
But that would soon change.
Building Foothills Hospital in 2003, and later moving the main hospital campus east to that location at Foothills Parkway and Arapahoe Avenue, was a strategic move, one driven with an eye toward the future.
It set forth a continued eastward expansion, one that mimics a countywide population shift as well.
“The move of our primary hospital location into eastern Boulder really parallels the move of the population growth into east Boulder County,” Vissers said.
Initially there were concerns about the potential impact of moving the main hospital from its central location in Boulder.
“What we discovered is that 90% of our employees actually lived east of where the new Foothills Hospital was so it significantly improved their access and transportation and getting to work,” Vissers said. “What it also did was it allowed us to better meet the needs of east county and the population growth that we’re seeing.
“It really became a much more central location for the population that we’re serving,” he added.
One hundred years ago, Boulder Community Health incorporated as a not-for-profit organization called the Community Health Association. This happened nearly two years after 26 local doctors bought the Ben Hagman residence at Broadway Street and Alpine Avenue and converted it into the 15-bed North Boulder Hospital.
In 100 years, the hospital system has evolved. In addition to moving its primary location, it has changed names multiple times and added services and satellite sites, among other adjustments.
Meanwhile, Boulder County has been changing alongside the system.
According to data from the State Demography Office, from 2015 to 2020, Boulder’s population hovered around 108,000, with a decrease of about 300 people from July 2019 to July 2020.
On the other hand, municipalities within the county — particularly Erie, Lafayette and Longmont — experienced fairly consistent growth.
Erie’s population, for example, grew by about 31% from 2015 to 2020 at an average annual rate of 6%.
Within the same time period, Lafayette’s grew by about 13% with an average rate of 3% annually. With the largest population of the three, the portion of Longmont that’s in Boulder County grew by about 7% with an annual rate of 1% annually.
Boulder County’s evolution is at least in part driven by housing, according to the State Demography Office.
“Housing development has been stronger within the communities located on the eastern side of Boulder County, typically attracting younger residents,” Demographer Cindy DeGroen said.
Younger residents means more families are now living in areas such as Louisville, Lafayette and Superior. The population under 18 is higher for most of the communities in eastern Boulder County, DeGroen confirmed.
This in turn impacts the services Boulder Community Health provides.
“For mom, baby care, we know that the population of babies being born is happening more in Lafayette, Erie, Longmont,” Chief Medical Officer Ben Keidan said.
As a primary care doctor, Keidan said he’s often thinking about how to improve access and make things easier for people.
“This is another sort of extension of that, is trying to meet people where they’re at so that they get access to services,” he added.
While the growth supports the notion of improving access to care for parents and children in the eastern parts of the system’s footprint, it also means the slower-growing municipalities are experiencing more rapid aging.
“Boulder County as a whole is expected to experience its fastest growth this next decade in the population aged 75 and over as the first of the large Baby Boomer generation turns 76 this year,” DeGroen added.
As Boulder County ages, so too will the need for services, according to a 2019 report produced by Boulder County.
“Based on the demographic shifts Boulder County will continue to experience over the next three decades, there will be an increasing need for accessible, affordable, and navigable public and private aging-related health, social and supportive services,” the report states.
Boulder Community Health is considering how to meet this need with everything from preventive services, including mammograms and colonoscopies; to joint replacement; ophthalmology and care for chronic illnesses such as cardiac disease, diabetes and cancer.
Additionally, care managers work with patients with multiple illnesses to monitor them and ensure that they’re taking the appropriate medications and that none of those medications are interacting poorly with each other.
That coordination of care is important, Vice President of Operations and Chief Nursing Officer Jackie Attlesey-Pries noted.
“We do really think that way — across the whole lifespan,” she said. “Again, that’s what BCH can do for individuals, is really support them throughout their lifespan because of our comprehensive services.”
In terms of considering the physical locations of the services it provides, Attlesey-Pries said it can be a challenge.
While the data indicates the western part of the county is aging faster, that doesn’t mean other parts of the county are void of older people.
“We think about making sure that they have access, but we don’t really put (services for older adults) in certain parts of the county because of the population,” she said.
As Boulder Community Health expands and adds new specialty services and facilities, it does so with a focus on the needs of the community.
And it employs something it calls the “smart growth strategy” in doing so.
“What we’re trying to do is use data and analytics to really understand the specific needs of our community,” Vissers said.
In doing so, the health care provider can recognize if there is an unmet need, including whether a particular disease set is underserved in a particular area.
For example, if it determines that the eastern part of the county is traveling west to access cardiology services, BCH could then move cardiologists into the eastern region.
“Being able to grow in a way that mimics the needs and the growth of our expanding community … makes sense for both of us,” Vissers said. “It keeps our providers busy but it also serves the needs of the people that live within the community.”
Elizabeth Cruse, an internal medicine doctor and ambulatory medicine department chair, wasn’t involved in the decision-making as Boulder Community Health moved its primary hospital location east to Foothills Hospital.
But she acknowledged it was done so out of recognition of the community’s eastward growth.
“We definitely recognize that that’s where people are living … trying to meet them as close as they can to where they live and to make it as convenient as possible for them,” Cruse said.
It’s important to meet patients where they are, but there’s also a benefit to a system that can provide everything from emergency services to behavioral health care, internal medicine, family services, primary care and more.
Because BCH provides wraparound services and doctors can access one medical record for patients within the system, it improves communication and reduces the risk of a patient falling through the cracks, Cruse noted.
“From a patient perspective, it’s really nice when your caregivers all kind of know each other and are communicating,” she said. “It makes them feel secure and like everybody knows what’s going on.”
Boulder Community Health in 2021 created a new mental health care program called the Pathways Partial Hospitalization Program and the Pathways Intensive Outpatient Program, both of which use mindfulness-based techniques, coupled with nature-based care.
Additionally, the Boulder Community Health Foundation has established the Anchor Point Mental Health Endowment, a fund that supports the mental well-being of patients along the continuum of care.
Still, when considering the future, mental health is an area with room for growth, hospital officials agreed.
For example, Keidan noted BCH continues to work to coordinate and integrate its in-patient and out-patient services, including services for adolescents.
Much like the way it’s expanding services for parents and babies east, it’s now considering how to improve mental health care for children in areas where those same families are.
“Mental health is definitely a key one,” Keidan said.
Likewise, Cruse said that as the county continues to change and grow, the hospital system will have to continue reevaluating its geographic locations.
“Because we’re growing, this area’s changing, it would be nice to be able to provide some services closer to where patients live,” she said.