Wyoming Medical Center officials have been meeting with their counterparts at Cheyenne Regional Medical Center to create a statewide "accountable care organization," the WMC's CEO said. That will require a cultural shift, in addition to changes in the ways the federal government reimburses hospitals for Medicare and Medicaid patients, Vickie Diamond said. "We're trying to create models that work for Wyoming," Diamond said. "We pride our independence, but this is a time for providers to come together," she said at the monthly meeting of the board of trustees of the Memorial Hospital of Natrona County. The board, appointed by the Natrona County Commission, oversees the lease of the county's hospital assets by the nonprofit Wyoming Medical Center Inc. The WMC's rent, in effect, is to provide care for the indigent and inmates in the Natrona County Detention Center. The discussions with the Cheyenne hospital began in 2010 after Congress passed the Patient Protection and Affordable Care Act, and have intensified as the paperwork piles up, Diamond said. "This is the year of regulation."