CHEYENNE — Concern about access to health care and to the right health care was the foremost comment Monday at a public forum on a new Medicaid study by the Wyoming Department of Health.

The state Legislature last winter mandated a study of the possible use of managed or coordinated care models to save money. The Medicaid program serves nearly 90,000 people in the state.

The first public forum on the matter drew about two dozen advocates, providers and consumers here Monday night. Consultants from Health Management Associates ran the meeting and plan a series of other meetings before submitting a report the the health department, possibly in early January.

The most common type of Medicaid coordinated care is risk-based managed care. That model has been adopted by 37 states. More than half of the states each have a Medicaid patient-centered medical home model, according to the consultants' report.

Richard Leslie of Cheyenne, founder of the Wyoming Epilepsy Association, told of the need for Medicaid patients with epilepsy to travel to obtain specialized care. He noted that Wyoming has six or seven neurologists but only one pediatric neurologist, who is located in Casper.

Previously his organization paid travel and lodging costs for families of a child with epilepsy who needed to go to Colorado to see a specialist. One current client, he said, is diabetic and needs to see an endocrinologist but none is currently practicing in Cheyenne.

Leslie said his question is how out-of-state providers can be linked into a coordinated or managed care system in Wyoming.

State Sen. Floyd Esquibel, D-Cheyenne, asked if the consultants are making allowances for the state's aging population. More than half the cost of the Medicaid program is for nursing home care for elderly people.

Another audience member said it would be good if the state had more clinics in rural areas so people didn't have to drive to Cheyenne or Casper.

Michealle Gady, the senior consultant with Health Management Associates, said the study will look at what other states have done with rural clinics. "We picked states like Wyoming so we can see where they were successful," Gady said.The next step, she said, is to continue research and put together a table that includes demographic information and infrastructure needs.

The consultants' report will include options and the cost effectiveness of each. The department will then select one model.

A health care public forum was held Tuesday night at the Casper Recreation Center.

The other public forums:

  • Wednesday, 5-7 p.m., Gillette: city of Gillette Community Room, 201 E. Fifth St.
  • Thursday, 1-3 p.m., Cody: Park County Public Library, Grizzly Room, 1500 Heart Mountain St.
  • Friday, 10 a.m.-noon, Green River: Green River Center, Room 211, No. 1 College Way.

Comments can also be sent by e-mail to:

Comments will be accepted until Nov. 5.

Contact Joan Barron at 307-632-1244 or

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