Pay 4 Participation

WYhealth Info and 24/7 NurseLine


Medicaid Providers have the ability to claim reimbursement for disease management referrals, disease management referral follow ups, screenings, and educational opportunities in the areas of diabetes, tobacco cessation, and preventative medicine counseling.  

What is the Wyoming Pay-for-Participation (P4P) Program?

The Pay-for-Participation (P4P) program allows Medicaid providers to receive additional reimbursements for:

• Providing health education to their Medicaid clients with chronic illnesses • Referring their clients into the WYhealth Care Management program

The program gives healthcare providers the additional support they need to help their clients live healthier lives and prevent the costly complications associated with chronic diseases. The primary goals of the program include:

• Preventing potential gaps in care • Improving clinical outcomes • Promoting client compliance with the physician’s plan of care

When a client is referred from a provider, a care management team member will contact the client and complete an assessment to determine the client’s level of participation and assess the client’s needs. Then, a member of the care management team will regularly call the client by phone to remind him or her to:

• Receive their annual preventive screenings • Make follow-up appointments with their provider as needed • Comply with their provider’s plan of care

By supporting the client with education and encouragement, the care management team helps bridge the gaps in care between prevention and treatment. Clients also have access to a 24/7 nurse line.

Are there additional benefits? YES!

• Practices will have the benefit of having a care management team that serves as an extension to the provider’s office, helping to bridge the gaps in care, coordinate care, and overcome barriers to care

How can your clinic get started?

Contact our staff by e-mail or phone.  We would be happy to schedule a meeting with the clinic staff to review all of the WYhealth programs and services.