you live in a county where PRIME is available and
What is PRIME?
At Rocky Mountain Health Plans, a UnitedHealthcare company, we partner with state leaders and local providers to design and implement innovative payment solutions that deliver equitable care for improved outcomes and lower costs. PRIME (Payment Reform Initiative for Medicaid Enrollees), our fully capitated managed care organization (MCO) pilot program, is a patient-centered, community-based systems change initiative that supports the physical and behavioral health care of Health First Colorado members.
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The Goal of PRIME
PRIME works to:
Improve the member experience
Improve how primary care medical providers (PCMPs) are paid
Make behavioral health available in a primary care setting
Improve access to health care in rural areas
Build upon our reinvestments in local Colorado communities
When PRIME Performs, Communities Benefit
PRIME relies on deeper, collaborative relationships between participating health systems, providers, and Rocky Mountain Health Plans. Together, we share responsibility for meeting its quality and cost goals. Success depends on provider contract flexibility, alignment of outcomes and incentives, local implementation, and a commitment of communities.
Since 2014, Rocky Mountain Health Plans has reinvested over $29.5 million to Colorado providers through the PRIME program — $25 million of which is tied to year-end reinvestment funding and $4.5 million tied to monthly PMPM reinvestment funding.
PRIME & RAE: Supporting Your Whole-Person Health Together
Every Health First Colorado member is assigned to a regional accountable entity (RAE), sometimes called a regional organization. RAEs help you manage your physical and behavioral health benefits and connect you to the care and resources you need. We serve as the RAE for Region 1.
PRIME covers adults and a small number of children with disabilities in Delta, Garfield, Gunnison, Mesa, Montrose, Ouray, Pitkin, Rio Blanco, and San Miguel counties. Health First Colorado members who live in counties where PRIME is available may be part of both PRIME and the RAE.
Get Started with PRIME
Your enrollment in PRIME is based on your application for Health First Colorado coverage.
After you apply for Health First Colorado coverage and your eligibility is confirmed, you will be automatically enrolled in PRIME if:
Learn More About PRIME
PRIME has gained state and national acclaim for its success. If you have questions or want to learn more about the program, please contact us.
Learn More About Our Commitment to Colorado
Discover more about Rocky Mountain Health Plans and how we’re working to improve health care for all Coloradans.
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