Rocky Mountain Health Plans

What it reported doing in 2016

Medicaid plansunder the medicaid aso agreement, rmhmo provided medical benefit services and programs to medicaid recipients in 7 rural counties, ensuring access to quality medical care not otherwise available, and saving taxpayer dollars while exceeding national benchmarks for quality. This program contractually ended in 2014 but the organization had run-out into 2016.expenses $ -183,477. Including grants of $ 0. Revenue $ 24,529.effective on september 1, 2014, rmhp launched a new medicaid payment reform pilot known as medicaid prime, which is authorized statutorily by the Colorado general assembly. New payment methods and quality metrics are being tested to improve access and value for Colorado medicaid recipients in a rigorous, externally evaluated demonstration. An average of 34,000 enrollees were served by rmhp in medicaid prime during 2016.expenses $ 167,150,377. Including grants of $ 0. Revenue $ 186,805,553. Children's health plan plus: through the Colorado department of health care policy and financing, rmhmo provided medical benefit services and programs to over 10,000 children in low-income households in 22 rural counties in western Colorado through participation in children's health plan plus program. These children gained access to high-quality medical care through a managed care program that provides case management and care coordination.expenses $ 14,808,910. Including grants of $ 0. Revenue $ 18,302,508. Regional care collaborative: 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 serves over 135,000 medicaid clients.expenses $ 13,438,700. Including grants of $ 0. Revenue $ 14,917,304.

Financial Efficiency

• Mission deployment rate: 88.9%; rating input score 89
• Program expense ratio: 88%; rating input score 88
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 68th percentile among comparable filings
• Pay-setting controls: 3 of 6 controls in place; rating input score 50
  • Compensation committee: Missing
  • Independent consultant: Pass
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Pass
  • Board or committee approval: Pass
• Foreign activity oversight: Limited
• Grant itemization coverage: 100%; rating input score 100; 77th percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Yes; rating input score 100

Accountability

• Independent voting board: 78.6%; rating input score 79; 29th percentile among comparable filings
• Governance controls: 9 of 9 controls in place; rating input score 100
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Pass
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: -1.1%; rating input score 20; 20th percentile among comparable filings
• Total-asset coverage ratio: 0.29; rating input score 11; 11th percentile among comparable filings
• Liabilities to assets ratio: 0.59; rating input score 31; 31st percentile among comparable filings
• Officer compensation ratio: 0.2%; rating input score 93; 93rd percentile among comparable filings

Growth

• Program expense growth: 13.9% per year; rating input score 100; 87th percentile among comparable filings
• Revenue growth: 11.4% per year; rating input score 100; 85th percentile among comparable filings
• Asset growth: 4.5% per year; rating input score 100; 45th percentile among comparable filings