The Wyoming Department of Health has reduced patient emergency room visits as well as improved its 30-day hospital readmission rate by mining state Medicaid data and utilizing a population health platform.
Xerox—Wyoming Department of Health's health management vendor—which analyzed data provided by the state’s Medicaid Management Information System to identify frequent users of ER and inpatient services as well as potential gaps in care, announced that since WYhealth started in October 2012, Wyoming has reduced Medicaid patient ER visits by 20 percent. The state’s 30-day hospital readmission rate also has dropped from 7.4 percent in 2012 to 6.88 percent in 2013.
Xerox’s staff of local clinicians works with patients and their physicians to put care plans and preventative measures in place. For example, if Medicaid clients have visited the ER more than 10 times in the past year, Xerox works with those individuals to find alternative resources for care in their community.
The organizations also watch for patients who fail to follow up with outpatient appointments or specific treatments after a hospital stay, as they are more likely to make additional ER visits or be re-admitted to the hospital. And Xerox staff works with high volume ERs to identify collaborative opportunities for intervention. With fewer ER visits, Wyoming Medicaid has reduced ER costs per member per month by more than 20 percent, it announced.
The department also provides a 24/7 nurse line that Medicaid patients can call any time of the day to help answer urgent health questions and determine whether or not they need to go to the ER. The nurse line can help patients learn more about their medical situation and identify the healthcare resource that best meets their needs.
“Our priority is to help people make informed decisions about their healthcare, like how to best manage chronic conditions and where to seek treatment when necessary,” James F. Bush, M.D., medical director, Wyoming Department of Health, said in a statement. “Xerox’s care management program enables us to support our patients in this way, and it reduces unnecessary and costly ER visits.”