Qualis Health Wins Wyoming Medicaid Contract for DME Review

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Two-year contract begins January 1, 2016 to assure appropriate utilization of durable medical equipment

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Qualis Health has signed a contract with the Wyoming Department of Health Division of Healthcare Financing, providing its expertise in utilization management to advance healthcare and improve health for people in Wyoming. Beginning January 1, 2016, Qualis Health will implement prior authorization and retrospective review of durable medical equipment (DME) for Wyoming Medicaid clients to minimize inappropriate utilization while assuring that care is tailored to the needs of enrolled Wyoming residents.

The Wyoming Medicaid program serves approximately 88,000 eligible individuals, and spent $7.6 million on DME, prosthetics, orthotics and supplies in 2014–a 20% increase over the past five years, when the number of enrolled recipients increased by only 6%. Qualis Health’s clinical review of DME services and claims ensures that prescribed equipment is appropriate to meet the needs of each client.

"We look forward to working with Qualis Health to help us assure that the Wyoming Medicaid program minimizes inappropriate utilization while providing for optimum services for our clients," said Amy Buxton. Provider Services Manager of the Wyoming Department of Health Division of Healthcare Financing. "This partnership supports the Department's mission to promote, protect, and enhance the health of all Wyoming citizens.

"At Qualis Health, we strive to contribute to improving value in the healthcare system by ensuring the delivery of high quality clinical services at a reasonable cost," said Jonathan Sugarman, MD, MPH, President and CEO of Qualis Health. "We look forward to assisting the Wyoming Department of Health to accomplish its strategic goals of improving health outcomes and strengthening program integrity."

Qualis Health also currently provides utilization management, quality review and population health management services for the Alabama, Alaska, Arkansas, the District of Columbia, Idaho, New Mexico and Washington State Medicaid agencies.

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About Qualis Health

Qualis Health is one of the nation’s leading population health management organizations, and a leader in improving care delivery and patient outcomes, working with clients throughout the public and private sector to advance the quality, efficiency and value of healthcare for millions of Americans every day. We deliver solutions to ensure that our partners transform the care they provide, with a focus on process improvement, care management and effective use of health information technology. For more information, visit http://www.QualisHealth.org.

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Evan Stults
Qualis Health
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