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Partnering for Colorado

Looking toward the future.

Our Vision: Regional Organization

As the regional organization for two regions in Colorado, our goal remains the same as it’s been for more than two decades: to partner with communities and empower people through access to quality, affordable care. We are transforming Colorado’s health care system by harnessing local innovation and local solutions into a truly integrated delivery system, which will improve individual and community health outcomes and make our health care system more efficient.

It takes everyone to create a new, evolved community system. As a regional organization, we’re forging a path for the broader community to achieve this integrated health care delivery system. Our regional organization model uses the Collective Impact Model within the Colorado Access Health Transformation Framework to align our service offerings upon a foundation of data to create a transformed health care system and improve health outcomes.

We envision our role as an organizing force, backbone, and gateway that will transform the regional health care system to benefit members and help drive the state’s overall health care reform vision. Our strategy involves working with members, providers and the diverse community in which we all live to create a common vision, develop shared measurement systems, conduct mutually reinforcing activities to attain common goals and communicate at every step of the journey.

Our vision for the RAE

When we look at health care in Colorado, we envision healthy communities transformed by the care that people want at a cost we can all afford. We’re working together to evolve the health of the people of Colorado.

African American mom and daughter reading

We cover more children through our CHP+ program than any other insurer in Colorado. We provide members access to primary and specialty inpatient, outpatient and ancillary care as well as community-based services and pharmacy services.

Our Vision: CHP+

The Child Health Plan Plus (CHP+) program provides low-cost health insurance benefits to children whose families earn too much to qualify for Health First Colorado (Colorado’s Medicaid Program) but not enough to pay for private insurance. As the largest CHP+ HMO in the state, we are proud to offer the largest CHP+ provider network. Additionally, we’ve administered the CHP+ State Managed Care Network for a decade, ensuring new CHP+ enrollees are covered until they select their HMO plan.

Our Vision: Long Term Care

We connect people with long-term care services and supports, offering a one-stop guide to living an independent life at home, especially for those living with chronic illnesses, disabilities or challenges. Once someone is eligible, we provide personalized care management and coordination of long term services and supports designed to keep people connected with programs that help them live healthier and more independent lives.

Man in wheelchair having lunch with friend

We are contracted with the state as the Single Entry Point (SEP) agency in five Colorado counties — Adams, Arapahoe, Denver, Douglas and Elbert.

We are actively working to strengthen the coordination of services thereby strengthening and growing the Health Neighborhood by doing the following:

  • Making sure clinical information is shared;
  • Ensuring patients receive appropriate and timely consultations and referrals;
  • Ensuring successful transitions of care;
  • Effectively guiding determination of responsibility in co-management situations;
  • Developing individualized care plans for members with complex health issues;
  • Collecting and analyzing the social determinants of health data across the neighborhood;
  • Building and strengthening community resource linkages.

Health Neighborhood

We understand that many factors beyond clinical care influence health. We believe a coordinated Health Neighborhood is fundamental to enhanced whole-person care. The Health Neighborhood is as an expansion beyond clinical health care services that includes a robust array of non-clinical community resources, public health and social services that promote and support the health of members and families. Essentially, the neighborhood is a set of relationships revolving around the member and their medical home, based on that member’s unique health care needs.

Integrated Health Care

We understand that easy access to both primary and behavioral health care is imperative as oftentimes a member’s physical health can’t improve unless certain behavioral factors are addressed. We are working to reduce the increasing financial burden of chronic disease and better member health outcomes by treating the whole person and addressing their physical health, mental health and substance abuse disorders together. We work with providers to optimize the physical and behavioral health of members, and promote and support the health of local communities.

Our fully integrated system of health care management includes both population health interventions and care management.

  • Population Health: Using integrated and coordinated care, data sharing/analytics and a number of outreach programs, we support providers of all types and sizes with administrative support that improves health outcomes.
  • Care Coordination: Each member has unique needs, which our model of care coordination addresses. We support the provision of care management services at the point of service, and have flexibly expanded care coordination in practices, hospitals, community agencies and non-traditional locations, such as public housing. For members suffering from complex health issues, we coordinate care in a way that makes sure their needs are met while simultaneously empowering them.
Provider showing patient information on tablet

In short, we’re all aiming for lower costs, better care and improved population health. The statewide agenda and goals for Health First Colorado provide the foundation for all of our efforts.

The Future of Health Care

We share the state of Colorado’s bold vision for sweeping transformation in Colorado’s health care industry and accelerated progress toward the Quadruple Aim: improving quality of care, reducing per-capita cost of care, improving patient and family experience of care and improving provider experience of delivering that care. Using alternative value-driven payment methods, informative data and analytics, and effective outcome measurement and performance improvement strategies, we’re transforming the health care system and improving health outcomes along the way.