In spite of the Grand Tetons, Wyoming didn’t spring to mind for forging new frontiers in healthcare until I talked to Dr. James Bush, Wyoming Medicaid medical director with the Wyoming Department of Health. With a “maldistribution” of only about 1,000 docs for about 550,000 patients, the state is a perfect candidate for testing out telehealth and mhealth meaningfully.
Here are four tips other rural states can take from Wyoming Medicaid:
1. Convince all payers to reimburse for telehealth.
Behavioral Health, Interoperability and eConsent: Meeting the Demands of CMS Final Rule Compliance
In a webinar on April 16 at 1pm ET, Aneesh Chopra will moderate a discussion with executives from DocuSign, Velatura, and behavioral health providers on eConsent, health information exchange and compliance with the CMS Final Rule on interoperability.
For rural constituents, this ultimately saves everybody cost down the line. (Duh.) But adding the weight of the state behind this effort pays off. It also allows state thought leaders to shift the emphasis to providers and solutions, rather than doing the who-pays-for-what shuffle.
2. Use the cheapest, most-modern technology you can.
In Wyoming, Bush said Logitech cameras provide a great example of this. It may not be the sexiest tech solution, but it’s affordable and gets the job done. Looking away from big expenses and toward “much more point-and-click” solutions gets the process moving faster and more viable.
3. Connect with mhealth startups for tailored apps when it fits the demographic.
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A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Wyoming Medicaid connected with Wildflower Health to create a pregnancy app to keep its patients healthy at the critical (and expensive) juncture of giving birth. Wyoming Medicaid pays for between 3,000 and 3,500 of the 7,000 pregnancies annually in the state, he said. And Wyoming Medicaid’s young adult female patients have access to smartphones.
To read more about DueDate Plus and how the state is using mhealth, click here.
4. Create real incentives for providers to report quality measures, use the data from EHRs. Think dollar signs.
When Bush was in private practice, he said he had to devote one full staff member to coding simple quality metrics and disease registries.
The wheels are in motion for Wyoming to offer docs $3 per member per month in reimbursement to report quality measures if they meet state thresholds, he said. That program could start this year.
He said Medicaid in Texas, Pennsylvania, New Hampshire, Vermont and Oklahoma are also leaders in telehealth and mhealth.
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