What is a regional organization

In Colorado, Medicaid is called Health First Colorado.  Every Health First Colorado Member belongs to a regional organization that manages their physical and behavioral health care.  Health Colorado is a regional organization and supports a network of providers to make sure Members can access care in a coordinated way.

Your PCP is your main contact for all your health care. They can answer questions you have about your benefits and help you get the care you need.  Health First Colorado will assign you to a PCP, but you can choose another in-network provider at any time.  You will be assigned a regional organization that your PCP works with.  Your regional organization can also help you use your physical and behavioral health benefits and can help connect you to providers.  Below is Health Colorado’s region:

Colorado regional organization Region 4 - Health Colorado

Health Colorado’s Role

Health Colorado will help you:

  • Assess or arrange for the assessment of medical, behavioral health, and psychosocial needs;
  • Establish a complete care coordination plan that address these needs;
  • Develop a Primary Care Provider (PCP) network and health neighborhood;
  • Coordinate referrals to specialty medical providers, human service agencies, or behavioral health services;
  • Facilitate exchange of information among multiple providers;
  • Monitor progress related to your care coordination plan.
  • Meet all regional organization’s care coordination requirements.

Health Colorado will:

  • Assess the member’s need for covered behavioral health services and develop a plan for these services;
  • Arrange for the delivery of medically necessary services, including inpatient level of care;
  • Develop and credential a network of behavioral health providers;
  • Develop processes for utilization management;
  • Facilitate transitions from one level of care to another (e.g., discharge planning);
  • Provide adequate access to behavioral health services included in plan including network adequacy standards.
  • Meet all contract requirements for the capitated behavioral health benefit.