The Healthy Together! program has identified almost 14,000 Wyoming residents who receive Medicaid and live with one or more chronic diseases, said Megan Cormier, executive director of APS Healthcare for Wyoming.

The program looks specifically at asthma, diabetes, depression, heart failure, coronary artery disease and chronic pulmonary problems.

Most people welcome the extra information.

It is important the program focuses on these people, Dr. Amy Trelease-Bell said, because chronic disease management can't be done alone.

"I can tell you in general, having a team address chronic disease management is beneficial," said Trelease-Bell, a general practitioner with the Family Medicine Residency Program in Cheyenne.

"There is more than one set of eyes, more than one person to call," she said. "Physician input is only part of the picture."

About 25 percent of the patients seen at her office are on Medicaid. The office recently started promoting Healthy Together!

Doctors were skeptical of the program in the beginning, Cormier said, but they've begun referring patients. Health coaches refer the patients back to the doctor if they need it.

If a person calls, the health coach will ask about symptoms. They will ask clients to think about self remedies instead of rushing to the emergency room.

For example, a woman can call and say her baby has a temperature of 103 degrees. The nurse can walk the patient through what to do and help the patient decide whether to seek outside help.

"Our goal is to help clients understand their options and not just run to the ER or their doctor's office," said Teri Green, manager of the state's Medicaid program.

Trelease-Bell said the program addresses some of the problems rural Wyoming has in the delivery of health care. For example, a lot of communities don't have diabetes education opportunities, she said.

The program can help people control their blood sugar levels.

"It's connecting people with a wider network when there is no local system," Trelease-Bell said.

Most importantly, Green said this program is about prevention and education.

"Let's not allow this person to end up with diabetes," Green said.