Provider Resources

Provider Resources



Population Health Management


Population Health Management and Shared Decision Making

Population Health Management is an integrated approach to health care that identifies patients with chronic medical conditions. This management program encompasses a number of initiatives designed to help patients reach and maintain good health, such as supporting the doctor-patient relationship and plan of care that emphasizes the control of their disease and its complications, and use of cost-effective, recommended guidelines and self-management tools.

Shared decision making is a joint process that allows you and your patients to make health care decisions together. WPS has various decision tools available to you throughout our website to use when making decisions about your patient’s health and care. You can review your patient’s results together and get an accurate picture of the risks versus benefits of treatment options.

For more information on supported self-care for patients, decision support tools for physicians, and enrollment/referral information, visit our Customer’s Health Management page.

Population Health Management Programs:

WPS covers all preventive immunizations* at 100%, including the influenza vaccination. If an office visit is associated with the vaccination and that office visit is billed utilizing a primary diagnosis showing immunization or vaccination, then that office visit is considered preventive and is covered at 100%. Additionally, WPS made it so that all preventative immunizations* administered at a pharmacy are covered at 100% as well, including the administration charge that is typically billed in conjunction with the charge for the vaccination itself.

With your help, better outcomes can be achieved when you are proactive about the flu vaccine. We encourage you to discuss the importance of the flu vaccine with your patients, as well as where they can obtain it.

Influenza Vaccination Resource

It is estimated that, if the diabetes epidemic continues, one in three Americans will develop the disease in their lifetime. As concern about diabetes increases, so does misinformation about the disease. It is common for people with diabetes to have other chronic conditions. These chronic conditions may include hypertension, chronic kidney failure, obesity, neuropathy, and congestive heart failure.

WPS offers care programs and services to its customers to help them understand the importance of following up with their primary care practitioner (PCP) or specialists after emergency room, urgent care or inpatient diabetic and comorbidity visit.

WPS has Population Health Specialists and Registered Nurse Case Managers who work together to coordinate programs for our customers to help them learn how to better manage their medical conditions by taking their prescribed medications correctly, creating a personalized action plan to discuss with their providers, eliminating or reducing environmental triggers, and incorporating active healthy lifestyles. If you have a patient who wants to participate in the Population Health Management Program, please call 1-800-333-5003.

Diabetes and comorbidities resources:

 

According to the Centers for Disease Control and Prevention, prescription opioids are often prescribed following surgery or injury to treat moderate to severe pain. In recent years, there has been an increase in the use of prescription opioids for the treatment of chronic pain, despite serious risks and lack of evidence about their long-term effectiveness.

Opioids are prescription drugs used to treat pain, such as oxycodone, hydrocodone, codeine, morphine, and others. While prescription opioids are generally safe when taken for a short time as prescribed by a doctor, they can be misused by taking them in a different way or in a larger dose than prescribed. Regular use can lead to dependence, overdose incidents, and death.

WPS has Population Health Specialists and Registered Nurse Case Managers who work together to coordinate programs for our customers' care. If you have a patient who wants to participate in the Population Health Management Program, please call 800-333-5003.

Opioid Resources

WPS offers care programs and services to its customers to help customers understand the importance of following up with their primary care practitioner (PCP) or specialists after emergency room, urgent care, or inpatient respiratory visit. The effects of respiratory disease in adults and children are a serious health and economic concern in the United States and among our customers. The Centers for Disease Control and Prevention (CDC) confirms that asthma is the most common chronic lung disease of childhood, affecting approximately 6 million children in the United States.

There are several environmental hazards that can trigger an asthma attack. One of those hazards is smoking, so any opportunity to assist a customer with finding a smoking cessation program may help eliminate one of their triggers.

WPS has Population Health Specialists and Registered Nurse Case Managers who work together to coordinate programs for our customers to help them learn how to better manage their medical conditions by taking their prescribed medications correctly, creating a personalized action plan to discuss with their providers, eliminating or reducing environmental triggers, and incorporating active healthy lifestyles. If you have a patient who wants to participate in the Population Health Management Program, please call 1-800-333-5003.

Respiratory resources

  • Asthma & Chronic Obstructive Pulmonary Disease (COPD) Management sensors mailed to you that attach to the inhalers you already have to record usage and send dosage reminders to your phone via the Propeller app. 1-877-251-5451 | Propeller Health
  • Centers for Disease Control and Prevention—Asthma
  • Children's Health Alliance of Wisconsin—Asthma
  • Centers for Disease Control and Prevention—COPD

   

Shared Decision Making

Shared Decision Making is a collaborative process that allows you and your patients to make health care decisions together.

With the Population Health Management Program, patients can enjoy:

  • A case manager designated to help patients feel better soon and coordinate their services by phone or computer.
  • Access to pharmacists that can help patients address their medication needs and concerns.
  • Simple ways to record patient symptoms and vital signs by phone or computer.
  • Information and resources on managing disease, medication management, healthy eating, exercise, and more.
  • Additional information obtained from monitoring co-morbid conditions.
  • Timely alerts regarding changes in the patient’s condition and vital signs.
  • Information for self-managing effectively to prevent an emergency.
  • WPS customers who saw a doctor for one of the disease conditions will receive a letter and/or phone call to determine their interest in program participation.
  • Doctor referrals are welcome. Call 800-333-5003 for referral requests.

   

*Preventative immunizations are those ranked A or B by the U.S. Preventative Service Task Force.

   

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