Shelley Mahoney drafted another member to her health care team about three years ago.

This particular health care provider is a little different from the other teammates.

Mahoney has never felt this provider's cold stethoscope against her or made an appointment to come visit her office. Mahoney has never met her.

Registered nurse Polly Snyder of Helena, Mont., has helped Mahoney control her asthma, deal with chronic pain and get through rough days.

And Snyder has done all this for the Casper resident over the phone.

Mahoney and Snyder are part of Healthy Together!, the state's Medicaid health management program. Mahoney is a Medicaid client and Snyder is her health coach, who calls at least every six weeks.

"It's a different opinion from the doctors and nurses," Mahoney said. "We can chat for an hour and you don't get that at a doctor's office."

The program began 2005, but state officials are just beginning to gauge the program's impact through research.

Many are impressed.

The program has saved the state millions of health care dollars. In 2006, the Wyoming Department of Health avoided about $17 million in costs as a result of the program.

Even though the idea came from a legislative mandate to the state health department to contain costs - Dr. Brent Sherard said it has made the state's Medicaid population healthier.

"The budget is showing the affects of the Healthy Together! program," said Sherard, director of the health department. "More importantly, people are understanding their own health situation better."

Wyoming Medicaid clients are having fewer emergency room visits and admissions to the hospital, said Teri Green, manager of the state's Medicaid program.

The Healthy Together! program is available to all of the state's 75,000 Medicaid clients.

Wyoming was the first state to focus on all clients, including the healthy ones, instead of just specific chronic diseases.

Every client has a health coach who calls and sends information depending on the client's needs. They remind clients to take medication, encourage them to get vaccinations and can even help them quit smoking or lose weight.

"This puts the burden on the client to start taking better care of themselves," Green said.

When first enrolled in Medicaid, people receive a letter about the program. Then, they will receive a call from a health coach asking if they want to participate in the program.

The state contracted with APS Healthcare to run the program. There are 17 health coaches working with Wyoming clients.

"Case managers open doors that haven't been open to people before," said Megan Cormier, executive director of APS Healthcare for Wyoming. Most people welcome the extra information.

Mahoney said she was relieved when Snyder called. She had just been diagnosed with asthma.

Through many phone conversations, Snyder taught Mahoney how to measure her breathing and gave her tips on what to do when she is having trouble.

Mahoney, who hates to take medications, received a call from Snyder every day in the beginning to encourage her to take her asthma pills.

Snyder said it can be a big shock to get a new diagnosis and she helps them adjust.

"They're doing all the work," Snyder said. "I just give them the tools."

As a health coach, she helps clients battle the depression that can come with some diagnoses. People have cried on the phone with her for hours and she just listens. Then she sends them a packet of information to get them started on treatment.

Over the three years, the two have worked together, Snyder has sent Mahoney folders of information on asthma, staph infections and even back aches.

Mahoney said she would recommend the program to anyone.

The number of Medicaid patients choosing to participate in this program on some level has steadily increased, Cormier said.

When clients decide to participate, they receive a 380-page health book. It offers tips on dealing with any health care problem - from losing 10 pounds to dealing with alcoholism to reducing vomiting.

And the book is just the first step.

Cormier said the program helps Medicaid clients understand themselves, access resources and services and talk to their doctors.

"They are empowered," Cormier said. "They have someone else to care about them."

The phone calls work, Snyder said.

She makes up to 32 calls each day to clients in Wyoming.

"I'm anonymous," Snyder said. "It's easy to bear your soul to someone you've never seen or will ever see."

And Mahoney knows Snyder is only a phone call away.

"There are days when things are under control," Mahoney said. "Then there are days when they aren't. That's when I call Polly."

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.

- Healthy Together! helped the state avoid $12 million in Medicaid costs in 2005, the first year of the health management program.

- In 2006, it saved the state $17 million.

- As of November 2007, 64 percent of Wyoming Medicaid clients, about 48,000 people, were participating in the program.

- Only about 10 percent actually opt out of the program every year. The rest are just unable to be contacted.

- The program reduced the number of emergency visits by Medicaid patients in 2006 by 17 percent. The total number of visits by Medicaid patients decreased in 2006 by 11 percent.

- The number of eligible clients with an inpatient admission decreased by 42 percent in 2006.

- The state pays about $5.50 per month for every person on Medicaid in the state.

- Medicaid asthma patients with a prescription for a life-saving rescue medication increased by about 10 percent from 2005 to 2006.

- Emergency room visits by asthma patients decreased in 2006 by 14 percent in 2006.

]]->