Managed Service Organizations (MSO)

The MSOs received a number of questions regarding the 1287 application process and funding. Questions were due on May 8th, and answers to the questions received are being posted here for your reference. Please utilize the document to help answer questions you may have, or refer back to the application for additional guidance. Thank you.

MSO Rural Expansion 1287

What is a Managed Service Organization?

A Managed Service Organization (MSO) is an entity designated by the Colorado Behavioral Health Administration to manage substance use services for adults and adolescents who are uninsured or underinsured in a specific region of the state. The MSO provides systems and financial management, data and tracking systems, and quality assurance functions. MSOs may subcontract with provider agencies for a variety of direct services. Beginning January 2023 there will be three Managed Services Organizations (MSO) in Colorado (as listed below).

• Rocky Mountain Health Plans (Substate Planning Areas, SSPA, 5 & 6) – Serving Archuleta, Delta, Dolores, Eagle, Garfield, Grand, Gunnison, Hinsdale, Jackson, La Plata, Mesa, Moffat, Montezuma, Montrose, Ouray, Pitkin, Rio Blanco, Routt, San Juan, San Miguel, and Summit Counties
• Signal (SSPA 1,2,4, 7)– Serving Boulder, Cheyenne, Clear Creek, Conejos, Costilla, Crowley, Denver, Douglas, Elbert, Gilpin, Huerfano, Jefferson, Kiowa, Kit Carson, Larimer, Las Animas, Lincoln, Logan, Mineral, Morgan, Otero, Phillips, Prowers, Pueblo, Rio Grande, Saguache, Sedgwick, Washington, Weld, and Yuma Counties
• Diversus (SSPA 3)- Serving Chaffee, Custer, El Paso, Fremont, Lake, Park, and Teller Counties

Note that SSPA 5&6 are currently administered by West Slope Casa who was unable to maintain their contract with the state of Colorado after 1/1/23 (due to recent Colorado conflict of interest legislation). RMHP was awarded the contract through a competitive bid process.

What do Managed Service Organizations do?

• Promote access to substance use services and help people locate care
• Fund substance use services for people who are low income and uninsured
• Contract with providers (often through capacity funding arrangements) to offer withdrawal management (detox), residential treatment, medication assisted treatment and outpatient treatment to individuals with substance use conditions who are unable to pay for care
• Monitor quality and access to care
• Fund recovery support services such as recovery living, peer support and community organizations supporting recovery
• Fund substance use services for families involved with child welfare to enhance and complement substance use core services funding
• Administer funds to build substance use treatment and recovery support capacity throughout their regions

Who are the providers currently contracted in SSPA 5 & 6?

RMHP is committed to maintaining funding for all current providers within the MSO program (within SSPA 5 and 6) and maintaining financial commitments that we made by the previous MSO. As RMHP and the BHA are able to expand funding opportunities, we will be identifying opportunities for exiting providers to expand their scope of services and for new providers who can receive MSO funding for the first time.

What are the MSO funding streams and service categories?

MSOs receive state and federal funding through a contract with the Colorado Behavioral Health Administration that is then used to fund local providers. Each program has different provider and Member eligibility and coverage requirements and often these programs receive other state, federal, and private funding. Many MSO funding agreements are on a capacity basis (meaning that funding is used to support the costs of maintaining program availability as opposed to fee-for-service funding models).

For questions, please contact RMHP MSO Support at RMHPMSOsupport@uhc.com, or by calling 970-822-4495.