What is The CO-OP
Had enough of the sky-high prices and impersonal service of big health insurance companies? You’re not alone.
We believe everyone in Idaho, Montana, and Wyoming deserves the financial security that comes with affordable health insurance. That’s why Idahoans, Montanans, and Wyomingites have come together to create a less expensive alternative to the big health insurance companies. One that’s run by its members, for its members—not Wall Street. One that shares profits with its members—not shareholders. One that’s focused on your needs—not just ours.
Why join us?
You can save money.
As a CO-OP member, you have a voice and a vote in how the CO-OP is run. Our board of directors, who govern our company, must be made up of a majority of our members – not big business.
Our plans are accepted by doctors and hospitals throughout the state.
What do we stand for?
Our Mission: We offer non-profit member-governed health insurance that promotes member engagement and provides access to high quality medical care.
Our Vision: Champion a more innovative, member-centric healthcare delivery system by promoting the triple aim where providers are engaged to improve population health , improve individual healthcare, and control healthcare spending.
Our Core Values: Customer focus, Communication, Quality, Integrity, Responsibility, Respect, Credibility, Innovation, Teamwork.
It all comes back to you.
The cost of health insurance and medical care are two of the greatest challenges facing us today. We believe big health insurance companies have had their way for way too long—and that Idahoans, Montanans, and Wyomingites have waited long enough. Help us bring some common sense—and competition—back to health insurance. Join us!
DBA Mountain Health CO-OP in Idaho, Montana, and Wyoming does not discriminate on the basis of race, color, national origin, disability, age, sex, gender, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.
Our Commitment to Your Care
Care and Utilization Management
Mountain Health CO-OP has contracted with the University of Utah Health Plans to both process claims, and oversee our care and utilization management programs. Through these programs, care and utilization management teams assist members in getting the right care at the right time. Through their work, these teams help our member achieve the best outcome, using nationally-recognized, evidence-based guidelines.
Quality Improvement Strategy
All of us at The CO-OP want to improve the quality and safety of health care. In order to know if we are improving, we measure how well we, and the professionals we work with, are doing over time. We work with many different health care providers to make your health and health care even better. Our clinical activities and programs are based on guidelines obtained from the best, proven medical best-practices we can find. We work to give you and your health care providers the information and tools needed to make good decisions.
We Aim To:
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Identify and meet the health needs of all of our members.
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Measure, monitor and improve the care that our members get. We look at both quality and safety.
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Understand and address racial and ethnic differences in health care.
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Come up with ways to do our jobs even better.
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Make sure we obey all the rules, including rules that come from federal and state regulators and accrediting groups.
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Help medical care providers understand the measurements of the care they give and where they are doing well or could do better.
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Make sure providers in our networks meet all of the standards.
Program Process & Expected Outcomes
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Medical
As Mountain Health CO-OP provides Marketplace plans, we collect data on clinical measures reporting to the Healthcare Effectiveness Data and Information Set (HEDIS®) and share the results with our accrediting organization, the National Committee for Quality Assurance (NCQA). We use the results to set new goals and improve our clinical programs each year. As a result, we expect improved member health outcomes on these measures over time.
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Also, we ask members how satisfied they are with Mountain Health CO-OP and how we can improve with both administrative processes and the medical care they receive. If medical needs are severe, we involve nurses and other healthcare professionals to directly help members get the best care.
Mountain Health CO-OP seeks to improve safety by providing information to physicians and members to help them make better decisions about medications and medical care options. We work with health educators to provide member training about the benefits of getting appropriate and timely care.
Behavioral health
Each year we monitor the effectiveness of our behavioral health (BH) programs are.
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We work to bring many behavioral health providers and facilities into our network of Montana clinical care providers
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We provide information and tools to our members, providers and BH staff to promote the use of medication according to doctors’ instructions.
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We encourage BH providers to use assessment tools that are based on the best evidence to improve the quality of care they provide.
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We work closely with providers to make sure that behavioral health care is provided in the best and most effective setting
Accreditation
We take our accreditation by the NCQA seriously. It’s how we show our commitment to:
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Finding ways to always keep improving
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Meeting people’s expectations
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Setting The CO-OP apart from other health plans
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You can get more information about our NCQA accreditations on the NCQA website
Board of Directors
Mountain Health CO-OP’s Board of Directors must include a majority of members — people with our coverage who want to help direct the future of the organization. If you are interested in joining the Board of Directors scroll down to see on how to secure a nomination.
Ray Rogers is the current Board Chair of the Health CO-OP. Mr. Rogers is a Chief Executive Officer for the National Center for Health Care Informatics (NCHCI), a Montana non-profit corporation. He resides in Butte, MT.