January 10, 2020
The Montana Department of Health and Human Services (DPHHS) awarded
Mountain-Pacific Quality Health a contract to help efficiently and cost-effectively improve health
outcomes for Montanans enrolled in Medicaid.
Medicaid provides free or low-cost health insurance coverage to more than a quarter of a million
Montanans who need financial help to receive medical and behavioral health services across the state or,
when necessary, outside the state. Through a review process, Mountain-Pacific helps Medicaid members
get the medical services, equipment and supplies that are most appropriate to their health and health care
needs. Under this new contract, Mountain-Pacific is subcontracting some of the work to Telligen, an
organization headquartered in West Des Moines, Iowa, with national Medicaid and quality improvement
experience. While Mountain-Pacific will still provide most of the Medicaid medical review services,
Telligen will be responsible for behavioral health reviews and other evaluations.
“Montana’s health care needs are always changing, and we knew we needed to come up with innovative
solutions to adapt to those changes,” said Sara Medley, Mountain-Pacific’s chief executive officer. “Our
staff has extensive clinical experience, and by partnering with Telligen and adding their expertise to the
mix, we will offer even higher quality services and technology to the State, to health care providers and,
most importantly, to Montana’s Medicaid members.”
Telligen also offers Montana Medicaid their industry leading technology platform, called QualiTrac. As
part of this platform, Mountain-Pacific and Telligen have introduced an online portal, where Montana
providers can submit review requests while keeping Medicaid members’ private medical records secure.
“We have received very positive feedback from our provider partners about the new portal,” Medley
said. “We all share the same goal, which is to advocate for patients and patient safety while making sure
Medicaid benefits are being properly used. This portal is part of how we make sure our Medicaid
support is as effective, efficient and least burdensome as it possibly can be.”
Mountain-Pacific has held Montana Medicaid contracts since 1974. The new, two-year contract started
on October 1 and will extend to October 2021 with an option for five, one-year extensions.
About Mountain-Pacific Quality Health — Mountain-Pacific is a 501(c)(3) nonprofit corporation and holds federal and state
contracts that allow them to oversee the quality of care for Medicare and Medicaid members. Mountain-Pacific works within
Montana, Wyoming, Alaska, Hawaii and the U.S. Pacific Territories of Guam and American Samoa and the Commonwealth
of the Northern Mariana Islands to help improve the delivery of health care and the systems that provide it. MountainPacific’s goal is to increase access to high-quality health care that is affordable, safe and of value to the patients they serve.
Learn more at www.mpqhf.org.
About Telligen — For more than 45 years, Telligen has been transforming lives and economies by improving health. Telligen
serves commercial clients and government programs at the federal, state and local level, improving health outcomes for
millions of people nationwide. Telligen is a 100 percent employee-owned ESOP company. For more information, visit www.telligen.com
Mountain-Pacific Quality Health Selected as a Recipient of QIN-QIO Task Order 1 Award under the 12th Statement of Work
November 14, 2019
On November 1, 2019, the Centers for Medicare & Medicaid Services (CMS) awarded a five-year contract to Mountain-Pacific Quality Health for $15.5 million to serve as a Quality Innovation Network-Quality Improvement Organization (QIN-QIO) under the recently launched 12th Statement of Work.
QIN-QIOs serving under this new contract will provide targeted assistance to nursing homes and community coalitions in small and rural areas, those serving the most vulnerable populations, and those in need of customized quality improvement. Through this body of work, CMS focuses on results, protecting taxpayer dollars, and most importantly, ensuring the safety and quality of care delivered to every beneficiary.
Under the new contract, Mountain-Pacific will continue to serve its current region, which includes Montana, Wyoming, Alaska, Hawaii and the U.S. Pacific Territories of Guam, American Samoa and Saipan.
“We started in Montana more than 45 years ago and have grown and expanded both in geography and breadth of services,” said Mountain-Pacific CEO Sara Medley. “We know our region and our communities well, and we have established trusted and valued local, state and national partnerships. We are eager to continue collaborating with health care providers, patients, caregivers and families to provide solutions for better health and improved health care that is more cost effective.”
Mountain-Pacific will be responsible for improving quality in poor-performing nursing homes, as well as small and rural communities and those serving vulnerable populations by:
Improving behavioral health outcomes, including opioid misuse
Increasing patient safety
Increasing chronic disease self-management
Increasing the quality of care transitions
Improving nursing home quality
Mountain-Pacific Quality Health
Pat Fritz, Wyoming Director
June 25, 2019
FOR IMMEDIATE RELEASE
Download PDF version here.
Wyoming Hospitals Receive Quality Health Care Awards
Casper, Wyo., (June 25, 2019) — Mountain-Pacific Quality Health is pleased to announce the winners of the 2019 Wyoming Hospital Quality Awards. The awards were presented to eight Wyoming hospitals during the Wyoming Quality Health Care Conference on June 25, 2019 in Casper.
Quality awards are given out each year to recognize Wyoming hospitals for their hard work and commitment to improving patient care. All recipients were required to reach six quality goals, including milestones in patient satisfaction, patient and family engagement and clinical care. Mountain-Pacific celebrates these hospitals and looks forward to another year of excellence in Wyoming health care.
“These hospitals demonstrated an outstanding and unwavering commitment to provide high-quality care to their patients,” said Pat Fritz, Mountain-Pacific Wyoming director. “We are honored to recognize their efforts and we truly appreciate their commitment of providing compassionate care to every patient.”
Eight hospitals received the Quality Excellence Award:
Memorial Hospital of Sweetwater County, Rock Springs
North Big Horn Hospital, Lovell
Campbell County Health, Gillette
Powell Valley Healthcare, Powell
Washakie Medical Center, Worland
Wyoming Medical Center, Casper
Ivinson Memorial Hospital, Laramie
Cody Regional Health, Cody
All Wyoming hospitals are eligible for Hospital Quality Awards. Award-winning hospitals range from small, rural hospitals to large, urban hospitals. Mountain-Pacific will continue to partner with Wyoming hospitals to help ensure that every patient receives the safest, highest quality of care possible.
About Mountain-Pacific—Mountain-Pacific is a 501(c)(3) nonprofit corporation and holds federal and state contracts that allow them to oversee the quality of care for Medicare and Medicaid members. Mountain-Pacific works within its four-state region (Montana, Wyoming, Alaska and Hawaii, which includes the U.S. Pacific Territories of Guam and American Samoa and the Commonwealth of the Northern Mariana Islands) to help improve the delivery of health care and the systems that provide it. Mountain-Pacific’s goal is to increase access to high-quality health care that is affordable, safe and of value to the patients they serve. www.mpqhf.org
Developed by Mountain-Pacific Quality Health, the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Montana, Wyoming, Alaska, Hawaii and the U.S. Pacific Territories of Guam and American Samoa and the Commonwealth of the Northern Mariana Islands, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Contents presented do not necessarily reflect CMS policy. 11SOW-MPQHF-WY-C2-19-126
Mountain-Pacific Quality Health
Mountain-Pacific Quality Health is a nonprofit organization that partners within our communities to provide solutions for better health. We first opened our doors in Helena, Montana, in 1973; since then, we have broadened our reach to include Wyoming, Alaska, Hawaii and the U.S. Pacific Territories of Guam, American Samoa and the Commonwealth of the Northern Mariana Islands.
Quality Innovation Network-Quality Improvement Organization (QIN-QIO)
Part of what we do is under the direction of the Centers for Medicare & Medicaid Services (CMS). We partner with health care providers, practitioners, stakeholders, patients and families on a variety of quality improvement initiatives to achieve better care, better population health and lower health care costs. These initiatives include:
- Preventing healthcare-associated infections in hospitals and nursing homes
- Preventing healthcare-acquired conditions related to long-term care in nursing homes
- Improving the coordination of care from one health care setting to another and reducing unnecessary hospital admissions and readmissions
- Improving cardiovascular health
- Improving the health and wellbeing of people with diabetes
- Helping providers with the use of electronic health records (EHRs) and health information technology (HIT)
- Helping providers with quality data reporting and related incentive programs
Mountain-Pacific provides Medicaid utilization review and management services for the Montana Department of Public Health and Human Services. We have been performing medical case review for specific Medicaid contracts since 1974. Through our review process, we strive to enable each Medicaid client to get his or her needs met in the most appropriate, cost-effective setting, using the most appropriate medical service, equipment and supplies.
Health Transformation Services
Health Transformation Services (HTS) is a department of Mountain-Pacific Quality Health. HTS is the federally designated Health Information Technology (HIT) Regional Extension Center (REC) for Montana and Wyoming. HTS offers technical assistance, guidance and information on best practices to support and accelerate health care providers’ efforts to become meaningful users of electronic health records (EHRs).