For Immediate Release

Cheyenne, Wyoming
August 24, 2009

Wyoming Department of Health’s Pay-for-Participation Program Reports Positive Clinical Outcomes

The Wyoming Department of Health reports success in two key aspects of its Pay-for-Participation (P4P) program, a component of its innovative Total Health Record initiative. The results demonstrate both increased collaboration between the practitioner community and the Wyoming EqualityCare (EC) Healthy Together program, as well as improved health practices of Wyoming Medicaid members.

There are currently more than 80 clinics participating in the P4P program and referring chronically ill patients into the Wyoming EqualityCare Healthy Together nurse coaching program. Both referral and participation rates have been high:

• 79% of diabetic patients that were referred worked with a health coach, as did
• 69% of patients diagnosed with attention deficit hyperactivity disorder and asthma

The P4P program has also improved the health practices of EC clients, as demonstrated by clinical outcomes results such as:

• 63% increase in the number of children and adults receiving a prescription for long term control of asthma
• Increased number of diabetics who had an HbA1c (glycosylated hemoglobin) test by 7.5%
• Increased number of diabetics who had a LDL-C (low density lipoprotein cholesterol) test by 36%
  

“These are the kinds of results we hoped for when we began the P4P program in 2007,” says James Bush, MD, State Medicaid Medical Officer. “They indicate that patients engaged with a health coach have better follow up and adherence with treatment plans and medications. Over the next few years this should translate into better outcomes as measured by reduced numbers of emergency room visits and hospitalizations, as well as fewer complications for patients.”

Once a practitioner refers a client, a Healthy Together nurse health coach monitors and evaluates progress, helps eliminate barriers to care, and encourages behavior changes to improve health outcomes. Clients receive disease-specific educational materials to help manage their illness, reminders to keep medical appointments, access to a toll-free 24-hour nurse support line, and links to community resources.

“The results are impressive, and I really appreciate the assistance health coaches provide to patients with chronic illness and their families,” says Catherine Depalma MD, a pediatrician in Evanston Wyoming. “And I have noticed there is a decrease in non-urgent emergency room visits since referring my patients into the program.”

“We are pleased with the initial results, and look forward to working with practitioners to continually improve them,” says Steven Saunders, MD, Chief Medical Officer of APS Healthcare, the organization that administers the Healthy Together program.

Phase one of the program started in July 2007, and was expanded statewide effective January 2008.

More information about the Wyoming Department of Health’s health management program can be found online at www.wyhealthytogether.com.

About APS Healthcare
APS Healthcare is a leading provider of specialty healthcare solutions to more than 20 million members in the United States and Puerto Rico. The company partners with agencies in more than 20 states, representing more than 40 percent of the nation’s Medicaid population. APS delivers customized, integrated healthcare solutions that help people engage in behaviors that optimize their health status. By uniting all participants in the healthcare landscape – individuals, practitioners and payers – APS improves overall health and reduces total healthcare expenditures. For more information, visit www.apshealthcare.com.

Michelle Crist
APS Healthcare Public Programs
Office: 307-433-0970