2017-10-14T22:00:04-05:00 2016-12-31 814510790 Grisier Bussey and Kaper CPAs 2135 N Seventh St Grand Junction CO 81501 990 2016-01-01 201632384 Quality Health Network QUAL 9702480033 744 Horizon Ct No 210 Grand Junction CO 81506 Richard Thompson Executive Director 9702480033 2017-09-13 1 James R Grisier CPA P00018693 9702438245 2017-09-07 X 69.146.254.163 2017-09-13 13:17:28 MD P E54EEC1ED39D52A69E25421F095AB1B200F3A253 D9FD5AB353067F81F952FF4E873CF50C8C980E59 2016 2018-03-14 21:41:22Z Richard Thompson 744 Horizon Ct No 210 Grand Junction CO 81506 4062631 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. 7 6 23 0 0 0 720000 420000 3112233 3624015 13282 18616 0 0 3845515 4062631 0 0 0 0 2223217 2286418 0 0 131642 827797 745773 3051014 3032191 794501 1030440 2690599 3816136 324040 419137 2366559 3396999 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 1427868 2118894 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 Institute for Healthcare Improvement's Triple Aim goal of - improving healthcare, improving the health of populations 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 2016, more than 3,500 providers, care team members and other healthcare staff were connected to the QHN network,and they made more than 2 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 2016, 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 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 and agreements are in process for the addition of a significant new hospital data source and provider group in Moffat county. This continued expansion will result in more than 96 percent of the providers in our service area being connected to the robust QHN data repository. In 2016 QHN completed 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 in contiguous states. 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). 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 17,500 messages exchanged in 2016. 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. 678318 1006594 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 chronically ill patients. These applications support population health management, risk stratification and 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. 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. This resulted in many providers being unaware of the outcome of care patients received in other care settings. The QHN patient longitudinal health record (Patient Summary) established for each of the more than 720,000 unique patients in the QHN system, is a comprehensive record of all care a patient receives from disparate sources. The frequency of provider access to the Patient Summary record are significant indicators of providers leveraging patient information across the continuum of care for improved integrated care. In 2016 QHN documented an average of more than 80,000 data repository server requests per month. Referring physicians, consulting physicians, discharge planners, long-term care facilities, hospice organizations & 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. 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 in 2014. 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 more than 135 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 & other healthcare providers. This makes it difficult for VAMC providers to coordinate veterans' care, something critical to improving quality & reducing costs & 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. In an effort to advance the exchange of ambulatory encounter information throughout 2016 QHN participated in two 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 practices to assist providers with enhanced HIE utilization, which may include the exchange of ambulatory encounter information, alert notifications, lab and radiology reports. 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 130 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 2016, 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 the three FQHCs in our service area to support this quality improvement and cost containment work and help reduce the burden on these government programs. 268565 398539 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 Regional Care Collaborative Organizations(RCCO-1), RCCO "PRIME", the Comprehensive Primary Care initiative (CPCi) and Sustaining Healthcare Across integrated Primary care Efforts (SHAPE). QHN continues to be engaged in a community care coordination pilot project, utilizing a care management toolset provided by QHN, which engages long-term care, home health providers, the Department of Health and Human Services and Rocky Mountain Health Plans for cross-continuum care management. One of the primary goals of this pilot is to decrease Emergency Department utilization and to decrease the burden on government supported healthcare programs. 67379 99988 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 2016, the Federal Poverty Level Guidelines set the poverty threshold for a family of four at $24,300. According to the MCHD the poverty rate in Mesa County is 14.4%; this is significantly higher than Colorado's rate of 11.5%. In Mesa County, about 8.0% of residents do not have any health insurance coverage compared with 6.7% in Colorado. More than 44,200 Mesa County residents are on Medicaid and more than 1,601 children are CHP+ members. Mesa County is significantly worse than Colorado in eight of the leading causes of years of potential life lost (YPLL). 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 the patients who seek care at the MCHD 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 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. 67379 99988 2442130 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 11 0 1 23 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 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/Director 1.00 X X 0 0 0 Bob Wilson Treasurer/Director 1.00 X 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 Richard Thompson Executive Director 60.00 X 246869 0 66543 Justin Aubert Chief Financial Officer 60.00 X 147572 0 34432 Marc T Lassaux Chief Technology Officer 45.00 X 163868 0 48406 Richard Warner Project Management Coordin 45.00 X 118590 0 35141 676899 0 184522 4 0 1 0 Rocky Mountain Health Plans PO Box 173704 Denver CO 802173704 Healthcare insurance 215391 Mirth Corporation 611 Anton Blvd Ste 500 Costa Mesa CA 92626 Software licenses and service 146747 Quality Systems Inc PO Box 511449 Los Angeles CA 90051 Software licenses and service 140225 3 420000 420000 Data Processing - Serv 518210 1852951 1852951 Data Processing - Subs 518210 1771064 1771064 3624015 18616 18616 4062631 3624015 0 18616 558308 446647 83746 27915 1116036 892828 167406 55802 201545 161236 30232 10077 288895 231115 43335 14445 121634 97307 18245 6082 66555 37906 26785 1864 28141 5631 21046 1464 36804 31284 3680 1840 5027 4129 671 227 88848 75481 8912 4455 47025 35269 9405 2351 16595 8006 7614 975 2578 2191 258 129 23179 19702 2318 1159 Consultants/Software/Sy 365056 355736 9320 Telephone 16454 13986 1645 823 Membership dues 14691 6555 8136 Marketing 12310 2462 8617 1231 22510 14659 7048 803 3032191 2442130 458419 131642 33967 2264979 3544798 410817 224886 87777 87777 2578 0 12225 12485 2690599 3816136 7142 15008 15885 15297 301013 388832 324040 419137 X 2366559 3396999 2366559 3396999 2690599 3816136 1030440 0 X 0 0 0 X X X 5 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 5 0 0 1 0 1 1 1 0 0 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. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 87777 87777 0 0 Accrued payroll 35259 Contingent Compensation payable 353573 388832 4062631 0 4062631 0 4062631 3032191 0 3032191 0 3032191 X X X 0 0 0 0 0 0 0 0 0 Richard Thompson Executive Director 180000 0 48869 0 18000 0 26691 0 39852 0 313412 0 0 0 Justin Aubert Chief Financial Officer 127572 0 20000 0 0 0 17548 0 16884 0 182004 0 0 0 Marc T Lassaux Chief Technology Officer 143868 0 20000 0 0 0 17548 0 30858 0 212274 0 0 0 Richard Warner Project Management Coordin 106590 0 12000 0 0 0 12480 0 22661 0 153731 0 0 0 Form 990, Part III, Line 4b 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 2016 QHN began work with the Colorado Department of Health Care Policy and Financing (HCPF) on several separate grant 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 Medicare providers, expand acquistion of ambulatory data, including data from behavioral health and long-term care providers to enrich the data repository in support of the common vision of improving outcomes for 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 7a The board consists of eight 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. Two members are at large. All members of the board elect the two members at large. One position on the Board was vacant as of the end of the tax year. 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. Line 15b: The Organization used a compensation survey and 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 2021 N 12th St Grand Junction CO 81501 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 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