Rocky Mountain Health Plans (RMHP) administers Medicaid services under the guidance and oversight of the Colorado Department of Health Care Policy and Financing (HCPF), the state agency responsible for Medicaid and other public health insurance programs in Colorado. As both a Regional Accountable Entity (RAE) and a Managed Care Organization (MCO), RMHP has implemented comprehensive measures to ensure access, quality care, and affordability for all Medicaid members.

Value over volume

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A key element of RMHP’s strategy to promote health equity is their commitment to value-based payment (VBP). Through VBP, RMHP reimburses specific groups of providers within its Independent Provider Network (IPN), focusing on outcomes rather than volume. This approach sustains quality health services for Medicaid members and allocates financial resources to those making significant efforts to reduce disparities.

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Violet’s role in value-based care

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RMHP’s emphasis on value over volume drives continuous innovation and evaluation of the criteria for enhanced reimbursements. Currently, RMHP’s tiered payment system considers geographic factors, provider capabilities, and care delivery to prioritized populations. We are excited to announce that RMHP has now incorporated Violet’s Verified Inclusive Organization designation into this framework. Our research confirms that Violet Benchmarks are a dependable quality measure, and we’re thrilled that RMHP is using them as a standard of provider capability, enhancing reimbursements for clinical staff within organizations that have achieved Verified Inclusive Organization status.

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Below are RMPH’s 2025 criteria and considerations for increased reimbursements for individual practices or organizations. 

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Geography:

• Provider organizations or practices serving a significant number of members from counties with extreme access considerations (CEAC).
• Provider organizations or practices serving a significant number of members from rural counties.
• Provider organizations or practices that have a brick-and-mortar location within a local Colorado county.

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Provider capability:

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Previously, RMHP included access to bilingual and safe-space providers as criteria, typically verified through provider attestations. Moving forward, RMHP is shifting to Violet’s Inclusive Organization Verification to determine reimbursement eligibility. Violet will benchmark RMHP's providers, providing objective insights into each provider’s language capabilities and cultural competence in serving BIPOC, LGBQ, and TGNC individuals. Aggregating these benchmarks will enable RMHP to more accurately identify inclusive practices and organizations among their partners, helping to qualify them for enhanced reimbursements.

In addition to achieving Violet verification, RMHP's weighted criteria now includes enhanced reimbursement for practices or organizations that employ providers specializing in critical areas such as child psychiatry, autism services, and eating disorders. They also prioritize providers trained to serve members with intellectual disabilities or enrolled in the DOJ’s Violence Prevention Network.

Serving prioritized populations:

• Provider organizations and facilities that cater to a significant number of members with a non-English primary language, Hispanic members, individuals identifying as non-white, those with social determinants of health needs, former or current foster care participants, and members with intellectual or developmental disabilities.

Supporting RMHP’s bid for Colorado's Behavioral Health Administrative Service Organizations

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In July 2024, the Colorado Behavioral Health Administration (BHA) rolled out its competitive Request for Proposal (RFP) process for Behavioral Health Administrative Service Organizations (BHASOs). Rocky Mountain Health Plan (RMHP) enhanced their bid by incorporating insights and data from Violet. 

BHA's vision is to ensure high-quality, equitable behavioral health services across Colorado. This ambitious goal requires BHASOs to not only manage care coordination and administrative services but also to embody a deep understanding of the communities they serve. Key stakeholder feedback highlighted the necessity of:

• Recruiting and retaining a diverse and culturally competent workforce.
• Improving access to care and breaking down treatment barriers.
• Ensuring that staff have lived experience or have demonstrated competence treating the communities they serve.

Violet's provider benchmarking data gives RMHP a detailed overview of the cultural competencies within their network. This includes the ability to:

• Assess the racial, ethnic, and linguistic diversity of their providers.
• Identify providers with experience delivering care to BIPOC, TGNC, and LGBQ communities.
• Identify counties with sufficient access to inclusive care and uncover access gaps that can be addressed with targeted training.

This data is crucial for meeting BHA’s requirement for health care staff who can offer culturally responsive care to the communities they serve.

The stakeholder engagement process that informed the BHA's RFP emphasized the importance of cultural competence and inclusivity. Violet addresses these key points through:

• Comprehensive provider cultural competence benchmarking: RMHP can demonstrate to BHA that their network includes providers who are not only diverse but also culturally competent. This aligns with BHA’s goal of reducing service gaps and improving care quality.
• Identity-centered care coordination: Violet's data supports RMHP’s long term goal of incorporating cultural competency data into provider directories, putting more control in the patient’s hands, and improving their health care experience.
• Upskilling Providers: Violet’s Clinical Quality Educational Interventions (CQEI) equip RMHP's network with the necessary skills to deliver culturally responsive care. These interventions are tailored to address specific disparities identified through Violet’s analytics.

RMHP also utilized Violet’s insights to secure an additional contract for the Managed Medicaid Health Plan under the ACC Phase III RAE bid process, administered by the Colorado Department of Health Care Policy and Financing.

“We need networks that reflect the communities they serve and offer affirming care. Health care is a deeply personal experience, and that’s where partnering with an organization like Violet make a difference. Violet creates a kind of safe space—it’s not about the government mandating providers to disclose all their attributes or specialties, nor is it about health plans demanding information to populate a directory that becomes outdated in days. Instead, Violet serves as an ongoing, trusted third party. They understand payer operations and engage providers in a meaningful, detailed way to truly drive change.”

_{Patrick Gordon, CEO}

_{Rocky Mountain Health Plans}

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