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TIN:
SCHEDULE O
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is atwww.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Inspection
Name of the organization
ROCKY MOUNTAIN HEALTH MAINTENANCE
ORGANIZATION INCORPORATED
ORGANIZATION INCORPORATED
Employer identification number
84-0614905
84-0614905
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION CONTRACTS WITH A RELATED ENTITY, ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC), TO PERFORM MANAGEMENT SERVICES FOR THE ORGANIZATION. HMC HAS A SEPARATE GOVERNING BOARD. THE COMPENSATION REPORTED ON PART VII AND SCHEDULE J FOR THOSE INDIVIDUALS WHO ARE NOT DIRECTORS OF THE ORGANIZATION BUT WHO ARE LISTED AS OFFICERS OR OTHER EMPLOYEES OF THE ORGANIZATION WAS PAID BY HMC. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ENTIRE 990 IS DISTRIBUTED TO EACH DIRECTOR. EACH DIRECTOR IS GIVEN THE OPPORTUNITY TO ASK QUESTIONS AND/OR PROVIDE COMMENTS PRIOR TO FILING. THE FORM 990 AND TAX RETURN IS APPROVED BY THE FINANCE AND AUDIT COMMITTEE OF THE BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH YEAR BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE COMPREHENSIVE CONFLICT OF INTEREST DISCLOSURE STATEMENTS. THE CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE MAINTAINED BY THE ORGANIZATION AND ARE REVIEWED ANNUALLY BY THE ORGANIZATION'S LEGAL COUNSEL. BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE COVERED UNDER THE POLICY. BEFORE EACH BOARD MEETING, LEGAL COUNSEL, THE CHAIR OF THE BOARD, AND THE CEO REVIEW THE AGENDA AND DETERMINE IF THERE IS A CONFLICT OF INTEREST POTENTIAL FOR EACH BOARD ACTION ITEM, AND DURING EACH BOARD MEETING LEGAL COUNSEL, THE CHAIR OF THE BOARD AND THE CEO ARE PRESENT AND DO THE SAME. IF THERE IS A POTENTIAL FOR A CONFLICT, THE BOARD IS ADVISED AND THE BOARD ACTS IN ACCORDANCE WITH ITS CONFLICT OF INTEREST POLICY. IF SOMEONE HAS A CONFLICT, THAT PERSON CANNOT PARTICIPATE IN THE DELIBERATIONS OR DECISION ON THE TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE OFFICERS INCLUDED ARE CEO, CFO, COO, MEDICAL DIRECTOR AND VICE PRESIDENTS. COMPARABILITY DATA IS USED TO DETERMINE COMPENSATION. A THIRD PARTY COMPENSATION EXPERT REPORT CERTIFIES THE REASONABLENESS OF THE COMPENSATION AMOUNTS. THIS PROCESS WAS USED IN 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 | COPIES OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST TO THE EXTENT REQUIRED BY APPLICABLE LAW. |
| FORM 990 PART XII LINE 2C | THE BOARD ASSUMES RESPONSIBILITY FOR THE AUDIT, WHICH IS DONE ON THE STATUTORY BASIS OF ACCOUNTING, AND SELECTION OF AN INDEPENDENT AUDITOR. |
| FORM 990, PART VII, SECTION A, LINE 1A, COMPENSATION INFORMATION: | EXCEPT FOR JAMES SWAYZE, ALL THE COMPENSATION INCLUDED ON SCHEDULE J IS PAID BY ROCKY MOUNTAIN HEALTH MANAGEMENT CORPORATION (HMC) A RELATED ORGANIZATION. HMC ALSO HAS A MANAGEMENT CONTRACT WITH ROCKY MOUNTAIN HEALTHCARE OPTIONS (HCO) WHICH IS A RELATED ORGANIZATION TO RMHMO AND IS LISTED IN PART IV OF SCHEDULE R. THE COMPENSATION ON SCHEDULE J AND LISTED IN PART VII OF THE FORM 990 FOR THE INDIVIDUALS LISTED ON SCHEDULE J (EXCEPT JAMES SWAYZE) IS 100% OF THE COMPENSATION PAID BY HMC TO THESE INDIVIDUALS. HOWEVER, APPROXIMATELY 89% OF THE SERVICES PROVIDED BY THESE INDIVIDUALS IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH RMHMO AND 11% IS ALLOCATED UNDER THE MANAGEMENT CONTRACT WITH HCO. |
| FORM 990, NARRATIVE STATEMENT: | ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION, INCORPORATED (RMHMO)D/B/A ROCKY MOUNTAIN HEALTH PLANS IS AN INDEPENDENT, NOT-FOR-PROFIT HEALTH BENEFITS PROVIDER THAT HAS SERVED THE HEALTH CARE NEEDS OF COLORADANS FOR OVER 40 YEARS. RMHMO UNIQUELY UNDERSTANDS COLORADO'S HEALTH CARE CONSUMERS. WE PROVIDE ACCESS TO AFFORDABLE, QUALITY HEALTH CARE ENABLING OUR MORE THAN 230,000 MEMBERS TO LIVE LONGER, HEALTHIER LIVES. RMHMO IS KNOWN AS A STRONG AND TRUSTED LEADER IN HEALTH CARE AND IS EVER COMMITTED TO ITS COMMUNITY BENEFIT GOALS. THE ORGANIZATION IS DILIGENT AND DEVOTED TO PROVIDING INNOVATIVE, QUALITY HEALTH PLANS, IMPROVING ACCESS TO HEALTH CARE COVERAGE, AND IMPROVING THE WELL BEING OF INDIVIDUALS, FAMILIES, AND THE COMMUNITIES WE SERVE. VISION WE ARE A COST EFFECTIVE, EFFICIENTLY RUN ORGANIZATION IN THE HEALTH CARE INDUSTRY. WE ADD VALUE TO EVERYONE WE TOUCH. MISSION WE TAKE THE INITIATIVE TO IMPROVE THE LIVES OF OUR MEMBERS AND THE HEALTH OF OUR COMMUNITIES BY OFFERING INNOVATIVE HEALTH PLANS, PROVIDING EXCELLENCE IN SERVICE AND CARE OF OUR MEMBERS, AND STAYING TRUE TO OUR TRADITION OF PUTTING PEOPLE BEFORE PROFITS. VALUES WE MAKE DECISIONS BASED ON THE WELL BEING OF OUR MEMBERS. WE ARE RESPECTFUL, COMPASSIONATE, AND FAIR. WE ARE INNOVATIVE AND ACTION-ORIENTED. WE HONOR THE RIGHTS OF PHYSICIANS AND PATIENTS IN MEDICAL DECISION-MAKING. WE ARE CATALYSTS FOR CONTINUOUS QUALITY IMPROVEMENT. WE BELIEVE THAT THE QUALITY OF OUR RELATIONSHIPS SHAPES OUR FUTURE. SERVING THE UNDERSERVED CHILDREN'S HEALTH PLANS PLUS (CHP+) & CHILDREN'S HEALTH PLAN PRENATAL SERVICES RMHMO OFFERS CHP+ COVERAGE TO INDIGENT CHILDREN AND CHILDREN'S HEALTH PLAN PRENATAL SERVICES TO PREGNANT WOMEN. IN 2015, RMHMO SERVED OVER 7,000 INDIGENT CHILDREN AND PREGNANT WOMEN UNDER THE CHP+ AND CHILDREN'S HEALTH PLAN PRENATAL SERVICES PROGRAM THROUGHOUT 22 COLORADO COUNTIES. THE RMHMO MEDICAID AND CHP+ PROGRAMS CONTINUALLY RECEIVE THE HIGHEST APPROVAL RATING IN ALL PROGRAM CATEGORIES, INCLUDING OVERALL RATING OF HEALTH PLAN. THIS ACHIEVEMENT EXEMPLIFIES A 40-PLUS YEAR COMMITMENT THAT ROCKY MOUNTAIN HEALTH PLANS HAS MADE TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE UNDERSERVED IN COLORADO. MEDICAID PRIME: EFFECTIVE SEPTEMBER 1, 2014, RMHMO AND THE DEPARTMENT OF HEALTH CARE POLICY & FINANCING ("HCPF") ENTERED INTO A NEW PROGRAM REFERRED TO AS "MEDICAID PRIME" TO REPLACE RMMHO'S THEN EXISTING MEDICAID PROGRAM. THE MEDICAID PRIME PROGRAM WAS THE RESULT OF A COLLABORATIVE EFFORT BETWEEN RMHMO AND HCPF. MEDICAID PRIME IS A PROGRAM DESIGNED WITH THE OBJECTIVE TO REFORM HOW THE MEDICAID POPULATION IS SERVED AND ENCOMPASSES AND ATTEMPTS TO INTEGRATE PHYSICAL HEALTH, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES. THE EFFORT TARGETS THE ENTIRE POPULATION BELOW 250 PERCENT OF THE FEDERAL POVERTY LEVEL. MAJOR PROGRAM THEMES UNDER THE PRIME PILOT PROGRAM INCLUDE: -PAYING FOR VALUE, NOT VOLUME -HEALTH EQUITY FOR VULNERABLE POPULATIONS -BEHAVIORAL HEALTH INTEGRATION AND "WHOLE PERSON CARE" -MORE FLEXIBILITY IN PROGRAM RULES, NOT MORE MONEY IN HEALTH CARE -PRIORITIZING RESOURCES WHILE ACCOUNTING FOR EVERYONE -ACCOUNTABLE COMMUNITIES, NOT ISOLATED PROVIDER SYSTEMS -SHARING DATA TO IMPROVE POPULATION HEALTH -SHARING BURDENS AND BENEFITS WITH PARTNERS -IMPROVING HEALTH CARE EFFICIENCY AS HEALTH INSURANCE COVERAGE EXPANDS THE GEOGRAPHIC AREA INCLUDED WITHIN RMHMO'S PLAN INCLUDES MESA, GARFIELD, PITKIN, GUNNISON, RIO BLANCO, AND MONTROSE COUNTIES. THE PROJECT IS THE OUTCOME OF NEARLY THREE YEARS OF DISCUSSION AMONG RMHMO, PHYSICIAN, HOSPITAL AND COMMUNITY MENTAL HEALTH CENTER LEADERS. ADDITIONAL PARTNERS INCLUDE THE MESA COUNTY DEPARTMENT OF PUBLIC HEALTH, FQHCS, INDEPENDENT PRIMARY CARE PRACTICES, AN ASPEN VALLEY EMPLOYER INITIATIVE, AND THE UNIVERSITY OF COLORADO DEPT. OF FAMILY MEDICINE. RMHMO AND HCPF WILL COLLABORATE TO STREAMLINE PROGRAM ADMINISTRATION, REFORM PAYMENT AT ALL LEVELS AND CREATE A MORE SUSTAINABLE, VALUE-ORIENTED MEDICAID DELIVERY MODEL IN WESTERN COLORADO. THE PURPOSE OF THIS REFORM IS TO ALIGN THE PAYMENT MODEL AT THE POINT OF CARE WITH QUALITY IMPROVEMENT AND COST CONTAINMENT OBJECTIVES FOR THE MEDICAID PROGRAM AS A WHOLE. AS PART OF A CONTRACT AWARD RECEIVED FROM THE COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING, RMHMO PROVIDES SERVICES AS PART OF A REGIONAL CARE COLLABORATIVE ORGANIZATION FOR THE MEDICAID PROGRAM, WHOSE GOALS ARE TO IMPROVE HEALTH OUTCOMES OF MEDICAID RECIPIENTS BY ADDRESSING HEALTH NEEDS AND TO CONTROL COSTS BY REDUCING INAPPROPRIATE USE OF HEALTH CARE RESOURCES, EFFORTS FOCUS ON PROVIDING CARE COORDINATION AND CARE MANAGEMENT SERVICES TO MEDICAID RECIPIENTS; PROVIDING A FOCAL POINT OF CARE; ENSURING POSITIVE PATIENT AND PROVIDER EXPERIENCES; AND APPLYING STATEWIDE DATA TO SUPPORT DATA-DRIVEN QUALITY IMPROVEMENT INTERVENTIONS. THE CONTRACT COVERS 22 COUNTIES IN COLORADO AND IN 2015 SERVED OVER 119,000 MEDICAID CLIENTS. COMPREHENSIVE PRIMARY CARE INITIATIVE (CPC) DURING 2015, RMHP MADE $1,600,000 IN PAYMENTS TO PRIMARY CARE PRACTICES OPERATING UNDER A SPECIAL AGREEMENT WITH CMS TO UNDERTAKE SUBSTANTIAL "PRACTICE TRANSFORMATION" EFFORTS TO IMPROVE HEALTH CARE QUALITY AND REDUCE TOTAL COSTS. UNDER CPC, MEDICARE, MEDICAID AND SEVERAL PRIVATE HEALTH INSURANCE PLANS ALL CONTRIBUTE ALIGNED, NON-VOLUME PAYMENTS, ALIGN THEIR MEASURMENT PROGRAMS AND SHARE DATA TO ACCELERATE THE PACE OF IMPROVEMENT. GRAND VALLEY HEALTH FAIR CONTRIBUTION AS A MAJOR SPONSOR WITH MORE THAN 100 HOURS OF LABOR CONTRIBUTED TO THE PROGRAM THAT HELPS TO PROVIDE MESA COUNTY WITH COMMUNITY HEALTH AND AWARENESS SCREENINGS. STRIVE (F/K/A MESA DEVELOPMENTAL SERVICES) IS A TAX EXEMPT ENTITY THAT PROVIDES SERVICES FOR DEVELOPMENTALLY DISABLED INDIVIDUALS. THE RMHMO CONTRIBUTION ASSISTS INDIVIDUALS, YOUNG AND OLD, WHO LIVE WITH DEVELOPMENTAL DISABILITIES TO HAVE ACCESS AND SUPPORT TO COMMUNITY SERVICES. COLORADO MESA UNIVERSITY (F/K/A MESA STATE COLLEGE) NURSING PROGRAM PROVIDE GRANT FUNDING TO EXPAND THE COLLEGE'S NURSING PROGRAM IN AN EFFORT TO INCREASE ENROLLMENT RESULTING IN A HIGHER AVAILABILITY OF LICENSED NURSES. ROCKY MOUNTAIN HEALTH PLANS FOUNDATION IS A TAX EXEMPT PUBLIC CHARITY. RMHMO'S CONTRIBUTION OFFERS SUPPORT TO NUMEROUS COMMUNITY PROJECTS AROUND THE STATE, SUCH AS: -HELPING INDIVIDUALS IN A HEALTHCARE CRISIS THAT NEED ACCESS TO SERVICES OR CARE, -CREATING INCENTIVES FOR PREGNANT WOMEN TO STOP SMOKING, -HELPING SCHOOLS OFFER MORE PHYSICAL ACTIVITY FOR STUDENTS TO DECREASE OBESITY AND INCREASE TEST SCORES. -SPEARHEAD, WITH GRANT FUNDS, A BEHAVIORAL HEALTH CLINIC THAT RESIDES WITH THE LARGEST PRIMARY CARE PRACTICE IN MESA COUNTY, COLORADO, WHICH AMONG OTHER THINGS, COORDINATED MENTAL HEALTH AND MEDICAL CARE FOR PATIENTS FROM SEVEN COUNTIES ON THE WESTERN SLOPE OF COLORADO. |
| WORKSITE WELLNESS PROGRAMS | PROVIDE TOOLS, RESOURCES, AND TRAINING TO ASSIST EMPLOYERS IN IMPROVING THE HEALTH OF THEIR EMPLOYEES. THIS COMPREHENSIVE PROGRAM FOCUSES ON PROMOTING WELLNESS AND PREVENTING ILLNESS. RMHMO IS NAMED A GOLD WELL WORKPLACE BY THE WELLNESS COUNCIL OF AMERICA. RECOGNITION IS EARNED BY SUCCESSFULLY MEETING RIGOROUS HEALTH PROMOTION STANDARDS. BY EARNING THIS PRESTIGIOUS DESIGNATION, WE ARE RECOGNIZED AS ONE OF THE AMERICA'S HEALTHIEST COMPANIES. |
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015
Additional Data
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