2018-10-18T11:21:25-05:00 2017-12-31 814510790 Grisier Bussey and Kaper CPAs 2135 N Seventh St Grand Junction CO 81501 990 2017-01-01 201632384 Quality Health Network QUAL 9702480033 744 Horizon Ct No 210 Grand Junction CO 81506 Richard Thompson Executive Director 9702480033 2018-10-16 1 James R Grisier CPA P00018693 9702438245 2018-10-16 69.146.254.163 2018-10-16 12:54:40 MD P 9992E00F5597415CA1C2A9E1E473737DD3327E94 9992E00F5597415CA1C2A9E1E473737DD3327E94 2017 2018-06-14 16:35:46Z Richard Thompson 744 Horizon Ct No 210 Grand Junction CO 81506 4783054 0 X n/a X 2004 CO See Schedule O Quality Health Network's (QHN) primary mission is to optimize the health of the more than 400,000 residents that reside in the Western Colorado medical trade area QHN serves. QHN's health information exchange(HIE) improves the efficiency, timeliness, and quality of the healthcare provided for all, with a focus on non-profit providers, Critical Access hospitals, public health services and Safety-Net providers, to reduce the burden on government programs. The services QHN provides improves the ability of healthcare providers to collaborate in, coordinate treatment, manage and prevent illness and reduce costly duplicative testing and medical errors that are attributable to insufficient access to timely, accurate clinical information. 9 6 24 0 0 0 420000 420000 3624015 4337463 18616 25591 0 0 4062631 4783054 0 0 0 0 2286418 2420859 0 0 140655 745773 1067048 3032191 3487907 1030440 1295147 3816136 5153639 419137 461492 3396999 4692147 X See Schedule O Quality Health Network's (QHN) primary mission is to optimize the health of the more than 400,000 residents that reside in the western Colorado medical trade area QHN serves. QHN's health information exchange (HIE) improves the efficiency, timeliness, and quality of healthcare provided for all, with a focus on non-profit providers, Critical Access hospitals, public health services and Safety-Net providers, to reduce the burden on government programs. The services QHN provides improves the ability of healthcare providers to collaborate in, coordinate treatment, manage and prevent illness and reduce costly duplicative testing and medical errors that are attributable to insufficient access to timely, accurate clinical information. 0 0 1647788 2536035 Clinical Data Acquisition,Aggregation and Delivery: Quality Health Network (QHN) was incorporated in 2004 and successfully launched live operations to improve the quality of healthcare in 2005. QHN utilizes a secure HIE network as the foundation for the services provided to health organizations and providers to support the Quadruple Aim in Healthcare - improving patient outcomes, improving the physician experience, improving patient experience, and reducing the cost of healthcare for all. Since its inception, QHN has continued a steady focus on its founding mission of expanding the opportunity, resources and infrastructure necessary to increase the widespread provision of high-quality coordinated healthcare. The provision of services by the QHN network has placed western Colorado in a strong position to achieve innovative,meaningful healthcare reforms. As of the end of calendar year 2017, more than 3,500 providers, care team members and other healthcare staff were connected to the QHN network and they made nearly 1 million data repository query requests to the Patient Summary record(patient longitudinal record). QHN facilitates the ability of area healthcare providers to collaborate and coordinate care through the secure exchange of information and securely communicate, in a manner fully compliant with HIPAA and all other patient privacy laws and regulations. During 2017, QHN continued its expansion with the addition of new providers and healthcare services, which currently total more than 325 associated health and human service provider organizations, long-term care facilities, home healthcare agencies and Hospice programs. These operations and expansions are in the Western Colorado medical neighborhoods QHN serves: Mesa, Delta, Montrose, Garfield, Pitkin, Hinsdale, Eagle, Ouray, Rio Blanco, San Miguel and Gunnison counties. In 2017, QHN also expanded into Moffat County and Vail adding two new hospitals and providers in the areas. This continued expansion will result in more than 95 percent of the providers in QHN's service area being connected to the robust QHN network. In 2017 QHN expanded the work for cross-state and cross-regional HIE-to-HIE connectivity. This is in an effort to improve the coordination and continuity of care, statewide, and as people travel across state borders. This HIE-to-HIE information exchange work was established statewide with Colorado Regional Health Information Organization(CORHIO), the HIE that serves the eastern part of Colorado and has been expanded to include the HIEs in Utah(UHIN) and Arizona(Health Current). In 2018, QHN will enable the HIE-to-HIE-exchange to other HIE's throughout the western United States and other parts of the country. This type of exchange, based on the Patient-Centered Data Home (PCDH)concept,is a cost-effective, scalable method of exchanging patient data among health information exchanges. HIE-to-HIE exchange is a critical step toward establishing a robust national interoperability infrastructure between regional and state HIEs. Considering the significant percent of the Colorado population that are "snowbirds and travel for recreation, the secure electronic transmission of information between healthcare providers across regional and state lines has translated into a significant exchange of clinical information with more than 27,000 messages exchanged in 2017. This robust exchange of patient information between and among HIEs translates into improvements in coordinated care, patient safety and reduced healthcare costs. QHN is also a participant in the federal Health and Human Services program to develop secure infrastructure for the nationwide exchange of health information called the eHealth Exchange. QHN delivers real-time, critical patient information and provides a robust repository of patient clincal data (Patient Summary Record) to treating providers serving patients in life-threatening as well as non-emergent care situations. The ability for treating providers to securely access patient records and send directed, encrypted patient clinical information via QHN's high-speed network improves transitions of care and health outcomes. This immediate access to patient data reduces the burden on Government by decreasing medical errors, duplicative testing and the expense associated with the manual delivery, storage and processing of paper records. 782791 1204758 Clinical ImprovementPopulation Health Management and Chronic Disease Management: While the chronically ill comprise a relatively small percentage of the total population, they historically account for a large percentage of the healthcare delivery systems resources and associated expenses. Medicare and Medicaid eligible populations suffer disproportionately from chronic illnesses. A key component of QHN's quality improvement activities is the provision and implementation of high value technical applications to support providers' ability to identify and manage the care of chronically ill patients. These applications support population health management, risk stratification, predictive modeling tools, and proactive care coordination to reduce the burden on these government supported programs. These tools help in the early identification and treatment of patients with chronic disease to improve patient outcomes and reduce healthcare costs. As the electronic network connectivity work in the QHN medical trade area continues to mature, the process to improve evidence-based, coordinated care for chronic disease is progressing by implementing these sophisticated applications. This helps providers move from the current system of episodic care to a coordinated system of care that creates and maintains healthy populations. QHN's network and advanced architecture supports the data needs of these applications to help providers integrate coordinated chronic disease management and preventive care into their workflow and make them more successful as they transition to new value-based payment models. Improvements in care require that these chronic disease states are not only managed and controlled during the patient visit, but that proactive management and patient engagement occur. This level of coordinated care is only practical with the support of these applications. QHN actively works to support providers' implement and use population health management and registry applications embedded in the provider's electronic health record (EHR) sytems. These registry applications provide for the longitudinal monitoring capabilities needed to proactively manage disease and aggregate outcomes for groups of patients or the entire provider's patient panel. Registries and other care coordination tools also enable providers to involve care team members to efficiently support the patient care process and actively engage patients in their disease management. Managing diseases via a registry is quickly becoming the expected best practice as providers develop more efficient means to care for patients. QHN supports nearly all of the more than 3,500 QHN users with their data needs for the utilization of registry tools embedded in their EHRs. Prescription drug and Opiod abuse is a major area of concern, not only in the state of Colorado but nationwide. In 2017, QHN was awarded a pilot project to improve access and use of the Colorado Prescription Drug Monitoring Program(PDMP) by enabling access to PDMP via the QHN System. QHN began working on the pilot program integration and anticipate it to be live in mid-2018 for St. Mary's Hospital providers to easily access the PDMP via the QHN System single sign on functionality. Improving Care Coordination and Care Transitions: The transition of a patient from one care setting to another is frequently the source of reduced system efficiency, duplicative diagnostic testing, and the impetus for increased medical errors. This transition may be from provider to provider, or from care setting to care setting such as, the hospital to rehabilitation facility, home health care or hospice facility. It is common for a patient to receive care and treatment from many disparate providers during a single episode of care. Having real-time, concise & accurate patient medical information available to all providers involved in the care of the patient during these transitions is essential for improved quality, safety and cost reduction. Prior to the availability of the QHN's secure electronic network, processes which transferred patient medical information between providers were paper-based manual processes, utilizing photocopying, fax and courier services, and many providers were unaware of the outcome of care patients received in other settings. The QHN patient longitudinal health record (Patient Summary) established for each of the nearly 800,000 unique patients in the QHN system, is a comprehensive record of all care a patient receives from disparate sources. The frequency of access to the Patient Summary record is a good indicator of providers leveraging patient information across the continuum of care for improved integrated care. However this number has slightly decreased in 2017 as QHN has enabled more robust interfaces delivering the patient information directly into the provider's EHR system. This is an important benefit as the information is readily accessible without the provider having to query QHN to determine if additional information is available. Referring physicians, consulting physicians, discharge planners, long-term care facilities, hospice organizations and care coordinators frequently access the data repository. Patients receive better, faster and more appropriate treatment due to the QHN system which rapidly exchanges current patient information amongst the patient's care providers when and where it's needed. Duplicative testing, medical errors and loss of crucial time, due to missing or incomplete medical information, are reduced through the use of the QHN system. 309929 476998 Indigent Care Support In QHN's medical trade area, the estimated underserved (uninsured or underinsured) population approaches 30 percent. This population tends to be transitory in nature, as the area attracts many seasonal & short-term workers in the farming, service and recreational industries. These underserved patients often "float" in and out of eligibility for insurance/financial assistance & other government supported subsidies - and present for care in multiple care settings. To effectively treat this population, access to current patient eligibility and clinical information from previous care episodes is critical. The QHN HIE supports equitable treatment for all patients - wherever they may present for care - by providing accurate patient demographics to authorized providers to assist with ascertaining eligibility and clinical information to support care coordination and continuity. The cohorts of underserved patients positively impacted by this QHN functionality are most frequently Medicaid and/or Medicare eligible. The resulting effect of this system functionality is more efficient, cost effective care for this underserved population, which helps reduce the burden on government. As a recipient of a grant contract with HCPF, QHN has focused on increasing the number, and enhancing the services offered, to QHN participants who serve the Medicaid population and Federally Qualified Health Centers(FQHCs) focused on treating the underserved. QHN not only supports individual care providers and organizations that accept and provide care for the indigent population but also supports the data needs of several programs focused on improving the care delivery models for the Medicaid population. These new models will replace the nation's reliance on fragmented, fee-for-service care. The models QHN is currently supporting include, Colorado's Accountable Care Collaborative Program and the Comprehensive Primary Care initiative (CPCi). 77757 119672 Support for Public Health Programs: QHN continues to work with public health and community providers to improve patient care and public health through the timely exchange of, and access to, health information. The Mesa County Health Department (MCHD) has a unidirectional interface with QHN for direct delivery of transcription and laboratory and radiology results and has been actively involved in the community care coordination pilot. In 2017, the Federal Poverty Level Guidelines set the poverty threshold for a family of four at $25,100. According to the MCHD, the poverty rate in Mesa County increased to 16.3%; which is higher than Colorado's rate of 13.2%. To better serve this population, MCHD and the FQHC in the Grand Junction area, the Marillac Clinic, formed a unique partnership with the Marillac Clinic co-locating a clinic within the health department. This has allowed patients who seek care at the MHCD to have quick and easy access to a full range of medical services, including vision and dental care. QHN is supporting these public health programs, MCHD and the Marillac Clinic, through its existing secure high-speed electronic data collection/delivery infrastructure. This infrastructure creates a mechanism to electronically deliver and query critical health information and to alert providers when an important health event occurs. 77757 119672 2818265 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 8 0 1 24 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 1 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Richard Thompson Executive Director 9702480033 744 Horizon Ct Ste 210 Grand Junction CO 81506 Gregory Reicks DO Chair 5.00 X X 0 0 0 Dan Sullivan MD Vice Chair 1.00 X X 0 0 0 J Michael Stahl Secretary/Treasurer 1.00 X X 0 0 0 Andrew Jones MD Director 1.00 X 0 0 0 Jeff Kuhr PhD Director 1.00 X 0 0 0 Bryce Lokey MD Director 1.00 X 0 0 0 Chris Thomas Director 1.00 X 0 0 0 Sally Schaefer Director 1.00 X 0 0 0 Kay Ramachandran Director 1.00 X 0 0 0 Jodie Atchley Director 1.00 X 0 0 0 Richard Thompson Executive Director 60.00 X 246699 0 53115 Justin Aubert Chief Financial Officer 60.00 X 190696 0 34208 Marc T Lassaux Chief Technology Officer 45.00 X 207313 0 49494 Richard Warner Project Management Coordin 45.00 X 120681 0 36901 765389 0 173718 4 0 1 0 Quality Systems Inc PO Box 511449 Los Angeles CA 90051 Software licenses and service 298101 Rocky Mountain Health Plans PO Box 173704 Denver CO 802173704 Healthcare insurance 256866 eHealth Global Technologies Inc PO Box 200735 Pittsburgh PA 152510735 Software licenses and service 158090 3 420000 420000 Data Processing - Serv 518210 2465250 2465250 Data Processing - Subs 518210 1872213 1872213 4337463 25591 25591 4783054 4337463 0 25591 1729146 1383317 259372 86457 223867 179094 33580 11193 339168 271334 50875 16959 128678 102942 19302 6434 95218 63671 28881 2666 31097 6309 22693 2095 5217 3913 1304 56252 47814 5625 2813 5050 4272 539 239 89802 76291 9007 4504 67474 50605 13495 3374 25571 11432 13500 639 24646 20949 2465 1232 Consultants/Software/Sy 596584 554639 41945 Meeting meals and refre 23689 9550 13500 639 Telephone 14506 12336 1446 724 Marketing 11576 5788 5209 579 20366 14009 6249 108 3487907 2818265 528987 140655 33967 3544798 4215134 224886 925532 87777 87777 0 0 12485 12973 3816136 5153639 15008 22914 15297 33650 388832 404928 419137 461492 X 3396999 4692147 3396999 4692147 3816136 5153639 1295147 1 X 0 1 X 0 0 X X X 6 Hilltop Health Services Corporation 742321009 10 1 0 0 St Mary's Hospital 840425720 3 1 0 0 Colorado West Healthcare System 840469270 3 1 0 0 Rocky Mountain Health Maintenance Organization 840614905 10 1 0 0 Marillac Clinic Inc 841085822 3 1 0 0 Rocky Mountain Health Foundation 841424932 7 1 0 0 6 0 0 1 0 1 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 Part IV, Section A, Line 3b: The Organization confirmed that a supported organization qualified under 501(c)(4) satisfied the public support test initially when the filing Organization sent a letter to the Service on February 15, 2008, changing the filing Organization status to that of a supporting organization. This letter described the application of the test to the supported organization. The test showed that the supported organization's public support percentage was 97%. The supported organization's business operation with regard to public support has not changed since the date of the filing of the letter with the Service. Therefore, it is unnecessary to continue to test the application of the public support test for this supported organization. Part IV, Section A, Line 3c: All support given to the 501(c)(4) organization which is a supported organization is controlled by the filing Organization because the support is in the form of services provided by the filing Organization. Part IV, Section A Line 5a - 5c Rocky Mountain Health Maintenance Organization, Incorporated (EIN 84-0614905) was removed because it was converted to a for profit corporation. Rocky Mountain Health Foundation (EIN 84-1424932) was substituted because its purposes are consistent with the purposes of the Organization. The Articles of Incorporation and Bylaws of the Organization were amended to accomplish this substitution of supported organizations. 87777 87777 0 0 Accrued payroll 38022 Contingent Compensation payable 366906 404928 4783056 2 2 4783054 0 4783054 3487907 0 3487907 0 3487907 Part XI, Line 2d - Other Adjustments: Rounding difference 2. X X X 0 0 0 0 0 0 0 0 0 Richard Thompson Executive Director 180000 0 48699 0 18000 0 10560 0 42555 0 299814 0 0 0 Justin Aubert Chief Financial Officer 130074 0 60622 0 0 0 16625 0 17583 0 224904 0 0 0 Marc T Lassaux Chief Technology Officer 146690 0 60623 0 0 0 16625 0 32869 0 256807 0 0 0 Richard Warner Project Management Coordin 108681 0 12000 0 0 0 12979 0 23922 0 157582 0 0 0 Form 990, Part III, Line 4b QHN is pleased that the Grand Junction Veterans Affairs Medical Center(VAMC) recognized the value of this data repository resource and signed an agreement to connect their providers and care team members to QHN. The providers at the VAMC have recognized the value of the QHN system for improved care coordination, and have continued to expand the number of VAMC users to nearly 150 utilizing QHN. Access to the extensive QHN clinical data repository by VAMC providers, continues to support quality of care improvements for the approximately 40,000 VA patients across western Colorado and eastern Utah. The large rural expanse & geographically challenging terrain western Colorado encompasses can make access to VAMC facilities difficult for veterans. Consequently, veterans must seek care from their community's local hospitals, physicians and other healthcare providers. This makes it difficult for VAMC providers to coordinate veterans' care, something critical to improving quality and reducing costs and the burden on government. The vast majority of providers in western Colorado are connected to QHN, allowing them to exchange critical health information when it's needed for care, regardless of where the patient is treated. Historically when veterans are seen at the local VAMC facilities, this information has not been accessible so VAMC providers were often unaware of the services their patients receive outside of the VA system. Care coordination & care transitions rely upon the successful and timely transfer of physician generated patient-centric progress notes & care plans between & among treating providers. This data can be summarized within the providers EHR system in a document called a Continuity of Care Document (CCD) or progress note. Every day thousands of healthcare providers across western Colorado access the QHN Patient Summary record in order to view inpatient and outpatient data, lab and radiology results. The data contained in QHN is of great value to providers and helps create a clinical picture of the patient. To advance the exchange of ambulatory encounter information throughout 2017, QHN continued participation in two major grant opportunities. The Colorado Advanced Interoperability Initiative (CAII) grant contract work is focused on the acquisition of encounter-based summaries from ambulatory settings, long-term care and behavioral health providers. The Medicaid 90-10 Health Information Technology (HITECH) administrative contract funding supports QHN's work with qualified Medicaid and referring organizations to assist providers with enhanced HIE utilization, which includes but is not limited to: the exchange of ambulatory encounter information, alert notifications, lab and radiology reports, single sign on, and image exchange. The goal of this grant contract work is to enrich and create a more complete patient longitudinal health record in the HIE, improve transitions of care and to support ambulatory and long-term / post-acute care providers via the exchange of clinical data. Currently more than 160 providers are exchanging ambulatory encounter data with QHN, which may include, CCDs, care summaries (transcription), progress notes, alert notifications and lab/radiology reports. QHN's secure network and uniquely connected technology, also allows authorized providers to receive hospital (emergency department, etc.,) Admission, Discharge and Transfer (ADT) alerts for real-time notifications of care occurrences that occur on their patients. During 2017, QHN continued to focus on the expansion of the delivery of ADT alerts to providers, care coordinators and organizations. Managing a patient's care across all care settings is the cornerstone of the new Medicaid and Medicare payment models. QHN is providing alerts to multiple FQHCs in QHN's service area to support this quality improvement and cost containment work and help reduce the burden on these government programs. While QHN's historical focus has predominately been on the medical side of a person's health,this does not include the many social factors that affect a person's health. In 2017, QHN launched a new initiative called the Community Resource Network (CRN). This social information exchange is designed to help bridge the gap by combining social, behavioral, and the medical side information to get a more comprehensive view of a person. CRN allows those involved in the coordinated care to view pertinent information to more efficiently guide the person to better health. This collaboration is critical to improve the health and safety of those QHN serves, reducing unnecessary duplication, reducing the burden on government supported healthcare programs, and ultimately driving down the cost of healthcare. QHN anticipates CRN to be in live production in mid-2018. Funding Sources: QHN continues to leverage the investments made by multiple grant contracts, past and present, to support the work required to build the technology infrastructure data inoperability exchange capabilities and robust data warehousing essential for the advanced analytics and data needs of new care and payment models. In 2017, QHN continued work with the Colorado Department of Health Care Policy and Financing (HCPF) on several grant contract opportunities. In addition, QHN continues to support the efforts of the State Innovation Model (SIM) initiative and the Testing Experience and Functional Tools (TEFT) grant which is designed to demonstrate the use of Personal Health Record (PHR) within the targeted populations of the intellectually and developmentally disabled, elderly, blind and disabled and identify and evaluate electronic long-term services and supports (e-LTSS) standard in conjunction with the Office of the National Coordinator (ONC). These investments have allowed QHN to increase and enhance connectivity with Medicaid and Medicare providers, expand acquistion of ambulatory data, including data from behavioral health and long-term care providers to enrich the data repository. This supports the common vision of improving outcomes for Medicaid, Medicare and all patients in Western Colorado. The collective impact of these acquisitions, and the practice transformation work they support, has been instrumental in the evolution of the healthcare delivery system of western Colorado. Form 990, Part VI, Section A, line 4 The Articles of Incorporation and Bylaws of the Organization were amended in 2017. The Articles of Incorporation were amended in March 2017 to remove Rocky Mountain Health Maintenance Organization, Incorporated as a supported organization and to add and substitute Rocky Mountain Health Foundation as a supported organization. Corresponding changes were also made to the Organization's Bylaws at the same time. Form 990, Part VI, Section A, line 7a The board consists of nine members. There are five tax exempt non-profit entities represented on the board and one taxable nonprofit entity. Each entity chooses a member to serve on the board. Three members are at large. All members of the board elect the three members at large. Form 990, Part VI, Section B, line 11b A copy of form 990 is provided to each board member before its' filing. Each board member is given an opportunity to comment on the 990 and ask questions before it is filed. Form 990, Part VI, Section B, line 12c Conflict of interest disclosure statements are reviewed by the Executive Director and legal counsel. All Board members, officers and key employees are covered under the policy. Before each Board meeting legal counsel and the Executive Director review the agenda and determine if there is a conflict of interest potential for each board action item and during each board meeting legal counsel and the Executive Director are present to do the same. If there is a potential for a conflict, legal counsel advises the Board and the Board acts in accordance with its' conflict of interest policy. If someone has a conflict that person cannot participate in the deliberations or decision on the transaction. Form 990, Part VI, Section B, line 15 Line 15a: The process is used for Executive Director (who is the top management official) compensation. The Board Chair, Board Vice Chair and Treasurer meet to determine the compensation amount relying on data of compensation rates for executives involved in health care in the Mesa County area. Their determination is documented contemporaneously in e-mail exchanges. In addition, in 2017 the Board had executive compensation reviewed by a compensation consultant. Line 15b: The Organization uses a compensation survey and/or a third party consultant to review salaries of several key positions including officers. Form 990, Part VI, Section C, line 19 No requests for these documents have been received. However, if such a request were made, we would provide a copy of these documents to the extent required by applicable law for 501(c)(3) organizations. Hilltop Health Services Corporation 1331 Hermosa Ave Grand Junction CO 81501 742321009 Rehabilitation services CO 501(c)(3) 10 N/A 0 St Mary's Hospital and Medical Center 2635 N Seventh St Grand Junction CO 81501 840425720 Full service hospital CO 501(c)(3) 3 N/A 0 Colorado West Healthcare System 2351 G Road Grand Junction CO 81505 840469270 Full service hospital CO 501(c)(3) 3 N/A 0 Rocky Mountain Health Maintenance Organization Inc 2775 Crossroads Blvd Grand Junction CO 81506 840614905 Health maintenance organization CO 501(c)(4) N/A 0 Marillac Clinic 2333 N 6th Grand Junction CO 81501 841085822 Health care to indigent population CO 501(c)(3) 3 0 Rocky Mountain Health Foundation 2768 Compass Drive Ste 109 Grand Junction CO 81506 841424932 Promoting health care activities in Western Colorado CO 501(c)(3) 7 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 St Mary's Hospital and Medical Center C 300000 Colorado West Healthcare System C 120000