Wyoming Medicaid Empowers Patients to Manage Care

By Jennie Echols

Feeling ill is often stressful – especially when you have questions about what your options are for getting care.  We are working with the Wyoming Department of Health to help give Wyoming Medicaid patients more informed choices about their care, like how to best manage chronic conditions, or where to seek treatment when it’s needed.

“Patients who are not connected with a primary provider and community resources are more likely to go to the ER, or be readmitted to the hospital.” –Jennie Echols, Ph.D., R.N., program director of Care and Quality Solutions for Xerox
“Patients who are not connected with a primary provider and community resources are more likely to go to the ER, or be readmitted to the hospital.” –Jennie Echols, Ph.D., R.N., program director of Care and Quality Solutions for Xerox

With our WYhealth program – a total population health management program – we look at data to identify frequent users of the emergency room (ER) and inpatient services.  Our staff of local clinicians then work with patients and their physicians to put care plans and preventative measures in place.

For example, Xerox will contact a Medicaid patient who has visited the ER multiple times in the past year, and we’ll work with the individual to link them with a primary provider and find alternative resources for care and support in their community. Xerox also watches for patients who fail to follow up on outpatient appointments or specific treatments after a hospital stay, as they are more likely to make additional ER visits or be readmitted to the hospital.

In addition to helping improve health outcomes for patients, WYhealth helps the state reduce costs associated with ER visits. Since the program was implemented in October 2012, Wyoming has reduced Medicaid patient ER visits by 20 percent, and the 30-day readmission rate dropped from 7.4 percent in 2012 to 6.88 percent in 2013. With fewer ER visits, Wyoming Medicaid has reduced ER costs per member per month by more than 20 percent.

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