Rocky Mountain Health Plans

What Rocky Mountain Health Plans does

Rocky Mountain Health Plans (RMHP) is a Colorado-based healthcare administrator and health plan that has operated continuously since 1974 and has been a wholly-owned subsidiary of UnitedHealthcare since 2017. The company functions as the Regional Accountable Entity (RAE) for Colorado Medicaid Region 1, the Behavioral Health Administrative Service Organization (BHASO) for Region 1, a Case Management Agency (CMA) for five designated service areas, a Dual Special Needs Plan (D-SNP) administrator for Medicare-Medicaid dual-eligible members, and operator of the PRIME value-based care payment reform program. Together these programs coordinate physical health, behavioral health, long-term services and supports, and social determinants of health resources for Health First Colorado (Medicaid) members across 36 counties.

RMHP's underlying technology is described as a healthcare administration and care coordination platform that integrates with Health Information Exchanges (Quality Health Network), uses Microsoft Teams and Zoom for member and provider engagement, and connects to ColoradoLIFTS and Colorado 211 for behavioral health and social service referrals. The organization publishes CMS Interoperability Reports for compliance and invests in HIE infrastructure for CMS 2026 interoperability goals. The PRIME program is nationally recognized for cost reduction in rural Colorado.

RMHP's revenue model is government-contracted managed services: capitation and administrative fees from Health First Colorado (Medicaid), a multi-year BHASO contract with the Colorado Behavioral Health Administration worth approximately $203.2 million in the first year, value-based payment arrangements that generate administrative fees and performance-based incentives, and Medicare Advantage premiums flowing through UnitedHealthcare for D-SNP. Members are acquired through state Medicaid enrollment assignment rather than direct sales. The organization reinvests a portion of administrative revenue into community-based organizations, provider payments, and workforce development programs including a $500,000 matching investment in Colorado Mesa University for social work loan repayment.

Name

Rocky Mountain Health Plans

Legal name

Rocky Mountain Health Plans

Website

https://rmhp.org

Company type

Private

Founded year

1974

Operating status

Operating

Headcount range

251–500 employees

Short description

Rocky Mountain Health Plans is a Colorado-based healthcare administrator and UnitedHealthcare subsidiary that serves as the Regional Accountable Entity, BHASO, and Case Management Agency for Health First Colorado Medicaid members across 36 counties.

Ownership category

akta.pro rank

Product category

Medicaid Managed Care Administration

NAICS

Health and Welfare Funds (525120), Outpatient Mental Health and Substance Abuse Centers (621420), Residential Intellectual and Developmental Disability, Mental Health, and Substance Abuse Facilities (6232), Services for the Elderly and Persons with Disabilities (624120)

SIC

Hospital & Medical Service Plans (6324), Services-Health Services (8000), Accident & Health Insurance (6321)

akta.pro primary industry

Managed Care Entity Administration for Medicaid (MCO/PHP/PIHP/PAHP) (HLAEAEAJ)

akta.pro secondary industries

Behavioral Health Managed Care (Medicaid) / BH Carve-In-Carve-Out Plans (HLAEAEAE), Behavioral Health Benefit Administration (MBHO Core) (HLAEAHAA)

Keywords

• Medicaid managed care
• Behavioral health services
• Case management services
• Medicare Advantage plans
• Healthcare administration

Headquarters

HQ city

Grand Junction

HQ country

United States

HQ region

North America

Offices5 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Others

Revenue model

1. Government Healthcare Contracts: RMHP generates revenue through contracts with the Colorado Behavioral Health Administration and as a Regional Accountable Entity (RAE) for Health First Colorado. The company received approximately $203.2 million in the first year from BHA to build regional provider networks for uninsured and underinsured patients. Additional revenue comes from D-SNP Medicare Advantage plans for dual-eligible members.
2. Value-Based Payment Arrangements: RMHP participates in value-based payment agreements that provide enhanced reimbursements to providers serving high-need members, including bilingual providers, rural/frontier providers, and those addressing social determinants of health. These arrangements generate administrative fees and performance-based incentives.

Go-to-market motion1 record

Distribution channels5 records

Marketing channels6 records

Core offering

Rocky Mountain Health Plans (RMHP) is a healthcare administration organization serving as a Regional Accountable Entity (RAE), Behavioral Health Administrative Service Organization (BHASO), and Case Management Agency (CMA) for Colorado's Health First Colorado (Medicaid) program. The company administers physical health, behavioral health, and long-term services and supports for assigned Medicaid members across 36 counties in Region 1, while also offering Dual Special Needs Plans (D-SNP) for Medicare-Medicaid dual-eligible members and the PRIME value-based payment reform program in rural Colorado.

Product overview

Rocky Mountain Health Plans (RMHP) operates as a multi-program healthcare administration organization with a portfolio of interconnected programs serving Colorado Medicaid members. The core offerings include: the Regional Accountable Entity (RAE) for physical and behavioral health coordination; the Behavioral Health Administrative Service Organization (BHASO) for mental health and substance use services; the Case Management Agency (CMA) for long-term services and supports; the Dual Special Needs Plan (D-SNP) for Medicare-Medicaid dual eligible members; and the PRIME value-based care program for rural Colorado. These programs serve different but overlapping populations across Region 1 Colorado, with RMHP acting as both a direct service provider and administrative coordinator within the Health First Colorado ecosystem.

Differentiator

Problem solved

Functional benefit

Brands

• BHASO (Behavioral Health Administrative Service Organization): RMHP serves as the BHASO for Region 1 in Colorado, responsible for establishing, administering, and maintaining regional safety-net behavioral health care services including crisis services, mental health services, substance use treatment, and care coordination.
• CMA (Case Management Agency)
• RAE (Regional Accountable Entity)
• PRIME (Payment Reform Initiative for Medicaid Enrollees)
• D-SNP (Dual Special Needs Plan)

Products and services

• Behavioral Health Administrative Service Organization (BHASO) BHASO is responsible for establishing, administering, and maintaining regional safety-net behavioral health care services for Region 1 in Colorado. Services include crisis services, mental health services, substance use treatment, and care coordination for children, youth, and adults regardless of ability to pay.
• Case Management Agency (CMA) CMA helps individuals and families access long-term care services and supports through Home and Community-Based Service (HCBS) waivers. RMHP serves 19 counties across five Designated Service Areas in Colorado, providing case management for individuals with disabilities or older adults requiring Long-Term Services and Supports.
• Regional Accountable Entity (RAE) RAE coordinates physical and behavioral health benefits for Health First Colorado (Colorado Medicaid) members in Region 1, connecting them to providers, specialists, counselors, and community resources including transportation, food assistance, and housing assistance. Covers 36 counties.
• Dual Special Needs Plan (D-SNP) D-SNP is a Medicare Advantage plan for individuals who qualify for both Medicare and Medicaid (dual eligible members). Offers specialized support, routine dental care, eye exams, hearing exams, transportation, and monthly credits for food and utilities, with more benefits than Original Medicare.
• PRIME (Payment Reform Initiative for Medicaid Enrollees) PRIME is a primary care-driven program supporting people, providers, and community organizations in rural Colorado. Operates within the Region 1 RAE to advance Medicaid reform through community reinvestments, enhanced provider payments, and cost savings. Available in Delta, Garfield, Gunnison, Mesa, Montrose, Ouray, Pitkin, Rio Blanco, and San Miguel counties.

Quantifiable outcome

• 84.3% of PRIME members get care when they need it (vs 80.3% Colorado RAE Aggregate)
• +6 more outcomes

Named customers8 records

Segments6 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration6 records

Partnerships

16 partnerships are on record, tiered core and minor.

• UnitedHealthcarecoreOthersParent company since 2017 acquisition; RMHP operates as a subsidiary leveraging UnitedHealthcare's expertise and resources while maintaining local leadership and community-focused culture. UnitedHealthcare provides operational support, technology, and brand association.
• Colorado Behavioral Health AdministrationcoreStrategic or Co-development PartnerState agency that contracted RMHP (as BHASO) and Signal Behavioral Health approximately $203.2 million in first year funding. BHA oversees regional behavioral health investments and faces potential budget cuts affecting the partnership.
• Northeast Health PartnerscoreStrategic or Co-development PartnerRMHP operates as subcontracted Administrative Services Organization (ASO) supporting NHP in delivering behavioral health functions for Region 2 RAE, including network development, contracting, and credentialing.
• Colorado LIFTSminorStrategic or Co-development PartnerColorado Linking Individuals and Families to Services - RMHP refers members to LIFTS for affordable mental health, substance use, and crisis care connection regardless of insurance status.
• Signal Behavioral Health NetworkcoreChannel Partner/ Reseller/ DistributorFellow BHASO contractor serving Regions 2, 3, and 4 while RMHP serves Region 1. Both organizations collaborate on behavioral health administration for Colorado under BHA oversight.
• Colorado Mesa UniversityminorStrategic or Co-development PartnerComprehensive regional public higher education institution in Grand Junction; RMHP invested $500,000 matching funding in 2024 to support student loan repayment initiative for Social Work program.
• Quality Health NetworkminorStrategic or Co-development PartnerWhole Health Information Exchange (Contexture affiliate) connecting people for better health; RMHP invests in health information exchange as part of community-based organization initiatives.
• Homeward Bound of the Grand ValleyminorStrategic or Co-development PartnerOrganization dedicated to eliminating homelessness in the Grand Valley; supported by RMHP community investments for housing assistance and health-related social needs.
• Raise the FutureminorStrategic or Co-development PartnerOrganization connecting youth in foster care with adults who become stable forces in their lives; supported through RMHP community funding initiatives.
• Colorado Cross-Disability Coalition (CCDC)coreStrategic or Co-development PartnerLong-standing collaboration where CCDC facilitates member councils with RMHP leadership, provides advocacy for disability community healthcare access, and participates in listening tours across Western Colorado.
• Western Slope Native American Resource Center (WSNARC)minorStrategic or Co-development PartnerOrganization supporting Native American communities in Western Colorado; RMHP invests in health equity programs and WSNARC helps navigate Health First Colorado coverage for tribal members.
• American Cancer SocietyminorStrategic or Co-development PartnerNational health organization partnered with RMHP for community health initiatives and resources for members.
• Mental Health ColoradominorStrategic or Co-development PartnerState mental health advocacy organization; supported through RMHP community funding for behavioral health initiatives and member education.
• Loving Beyond UnderstandingminorStrategic or Co-development PartnerNonprofit providing safe spaces, counseling, and resource navigation for LGBTQ+ youth and adults in Grand Junction and rural communities; Founder serves on BHASO Regional Advisory Council.
• Delta County Ambulance DistrictminorStrategic or Co-development PartnerEmergency medical services provider in Delta County; supported through RMHP community reinvestment and PRIME payment reform initiatives.
• Health Solutions WestminorStrategic or Co-development PartnerBehavioral health organization with Regional Outreach Director serving on BHASO Regional Advisory Council for Garfield, Eagle, and Pitkin Counties.

Scale indicators6 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Centene Corporation: Largest U.S. Medicaid managed care operator with significant Colorado presence and national scale. Provides benchmark for Medicaid MCO operating model, government-contract dependence, and value-based care execution at enterprise scale.
• Molina Healthcare: National Medicaid-focused MCO with state contracts across the U.S. Comparable business model centered on government-sponsored healthcare administration, including dual-eligible and behavioral health programs relevant to RMHP's portfolio.

Direct peers

• Denver Health Medical Plan: Colorado-based Medicaid Managed Care Organization serving Health First Colorado members. Competes with RMHP for Medicaid enrollment in overlapping counties and offers comparable CHP+ and D-SNP products in the state.
• Northeast Health Partners: Colorado RAE for Region 2, with RMHP operating as subcontracted ASO supporting behavioral health functions for NHP. Directly comparable Medicaid managed care and behavioral health administration peer in an adjacent Colorado region.
• Colorado Community Health Alliance: Operates as a Regional Accountable Entity for Colorado Medicaid in regions outside of RMHP's Region 1 footprint. Directly comparable as a fellow RAE with similar care coordination, value-based payment, and provider network responsibilities.
• Kaiser Permanente Colorado: Integrated health system offering Medicaid (Health First Colorado) and Medicare Advantage plans in Colorado. Competes with RMHP for value-conscious Colorado members, particularly those seeking integrated provider-health plan offerings.
• Signal Behavioral Health Network: Fellow Colorado BHASO contractor serving Regions 2, 3, and 4 alongside RMHP's Region 1. Operates the same Behavioral Health Administrative Service Organization model under Colorado BHA oversight, making it a like-for-like behavioral health administrative peer.
• Colorado Access: Colorado-based nonprofit health plan administering Medicaid managed care and serving as a Regional Accountable Entity (RAE) in other Colorado regions. Directly competes with RMHP for state Medicaid contracts and serves overlapping dual-eligible populations.
• Anthem Blue Cross Blue Shield of Colorado: Operates as a Colorado Medicaid MCO and offers Medicare Advantage plans including D-SNP products. Competes head-to-head with RMHP for dual-eligible and Medicaid members, particularly in urban-adjacent counties overlapping RMHP's Region 1 footprint.

Others

• UnitedHealthcare (parent): RMHP's parent company since 2017, providing operational, technology, and brand backing. Although not a market peer, UnitedHealthcare's national D-SNP and Medicaid footprint defines the strategic envelope within which RMHP operates and competes.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/rocky-mountain-health-plans
• Xx.com/RMHP

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Rocky Mountain Health Plans