What is Monument Health?
Monument Health is a clinically integrated network, which is a team of independent health care providers working with patients and with each other to provide better health care at a lower cost. Employers may access the Monument Health clinically integrated network via our health plan partner, Rocky Mountain Health Plans (or via a third party administrator if self-insured).
Which Monument Health plans are available to my organization?
Large employer groups (100+ employees) and small employer groups (fewer than 100 employees) may access the Monument Health clinically integrated network through competitively priced Rocky Mountain Health Plans products. There are five small group plans offered for calendar year 2017, and RMHP will customize large group plans per employer group preferences. Self-insured employer groups may also access Monument Health via their third party administrator (TPA), with CNIC as our preferred TPA partner.
Why is Monument Health changing the way things are done?
Things in health care are ever-changing, access to care is diminishing and costs are on the rise. Monument Health’s founding partners and its network providers believe a different approach to health care is necessary–specifically a truly integrated approach, which offers better care and lower costs and eventually a healthier Mesa County. We are committed to this approach now and well into the future.
What does offering Monument Health mean for my organization and our employees?
Monument Health plans save money and produce better outcomes. Having healthier, more satisfied employees likely means less absenteeism, more days on the job and improved productivity. We encourage members to select Monument Health (Tier 1) providers and facilities where they will have accessible, appropriate and more affordable care. Members will have guaranteed access to Tier 1 primary care practices, and efforts will be made to accommodate urgent needs with same-day or next-day appointments. If members need specialty care, they can access it right here in Mesa County, close to home. And because our providers work together as a team and confidentially share data, members are less likely to experience repeated or duplicated tests and procedures. This saves frustration, time and money.
How do the “tiers” work and is Monument Health a “narrow network?”
The Monument Health plan–whether an RMHP fully insured plan or a self-insured plan–is indeed a tiered plan. In the Monument Health (Tier 1) network, providers are working with members and with each other to provide the best care at the lowest cost. We believe the Tier 1 network is fairly broad in that the majority of primary care providers in Mesa County (five practices and 120+ providers) are part of our network. Many Mesa County specialists, a regional medical center, a behavioral health hospital and multiple other ancillary services are also in the Monument Health network.
Members may also see Tier 2 providers in Mesa County, throughout Colorado and even nationwide. For RMHP and CNIC health plans, Tier 2 includes providers in the RMHP statewide network and the First Health National Network. For Cigna health plans, Tier 2 includes providers across Colorado and nationwide who are in the Cigna national network.
Members may also see Tier 3 providers who are considered “out-of-network” and who are generally associated with the highest costs. All emergency room care is covered at the Tier 1 benefit level without exception. And most urgent care is also covered at the Tier 1 benefit level.
What are Monument Health providers doing differently?
Monument Health providers are doing three things differently to improve care and lower costs.
- First, these practices and hospitals have demonstrated, by meeting national standards, the commitment and ability to put patients at the center of care and to deliver care more efficiently and more smartly.
- Second, these practices and hospitals confidentially share data and follow very specific guidelines to work as a team.
- And third, physicians in our Tier 1 practices and hospitals are paid on how well they take care of members, not how many patients they see each day.
What wellness benefits are available when working with Monument Health?
Wellness benefits may be accessed through your plan administrator, plus other local resources. Members accessing Monument Health through Rocky Mountain Health Plans-insured products are invited to use “Café Well.” Members accessing Monument Health via Cigna are invited to use the “Partners in Health” portal. And please consider HealthTop–a robust and local resource offered by Hilltop Community Resources.
How can my organization offer “choice” to employees yet optimize the Monument Health value?
Members are strongly encouraged to select Monument Health (Tier 1) providers and facilities to optimize their care experience and to ensure the lowest cost for both the member and the employer organization. Members are not required, however, to use Monument Health providers or facilities exclusively and may continue to see any provider they wish.
How will my employees and my organization be supported when we need assistance?
Onboarding and open enrollment support will be available to benefits professionals. And both benefits professionals and employees may contact the Monument Health team, a local resource, at (970) 683-5630 or email@example.com. Additionally, if your organization accessed Monument Health via a Rocky Mountain Health Plans (RMHP) product, members may contact RMHP Customer Service at (970) 244-7912 or (888) 282-1420 from 8 a.m. to 8 p.m. , or via “live chat” from 8 a.m. to 6 p.m. And if your organization accessed Monument Health via Cigna or CNIC, customer service may be reached at (800) 426-7453 from 8 a.m. to 8 p.m. for CNIC, and at (800) Cigna24 at any time, day or night, for Cigna.
Can Monument Health help my organization navigate the ACA requirements and other policy updates?
Monument Health highly values the experience and expertise of our broker and consultant partners who are best equipped to support your ACA or other health care policy needs.
What does a transition from another health insurance product to a Monument Health product involve?
Monument Health, along with your broker and plan administrator, will work together to support you throughout the entire process, from contracting through onboarding. We will provide a toolkit consisting of high-impact collaterals that are clear and simple to support you and your organization during the open enrollment period. Monument Health offers on-site support from local experts who live right here in Mesa County during your organization’s open enrollment sessions, benefit fairs, biometric screenings, etc.
What visibility does my organization have into our quality and cost data?
The Monument Health organization is built on measurement, collaboration and transparency. Our self-insured partners will have access to an employer dashboard (accessed securely through a link on the For Employers page) that contains their quality and cost data. Our fully-insured partners may also have access to data. And we always invite in-person discussions or operating reviews to review the data and programmatic updates, share feedback, etc.
How do I help my organization take the next step with Monument Health?
Call Monument Health at (970) 683-5630. And please note, we highly value the experience and expertise of our broker and consultant partners, and we look forward to assisting you with a referral as appropriate.
How do deductibles accumulate under Monument Health employer plans?
We’re happy to answer detailed questions about the plan you’re considering, like questions about deductibles and how they may or may not accumulate. Please call us at (970) 683-5630.
Call us. 970.683.5630