Our Clients
Physician Health Partners is a management service organization that currently supports two independent physician associations (IPAs): Colorado Pediatric Partners (CPP) and Primary Physician Providers (PPP). These IPAs practice within the ten county metropolitan region surrounding Denver and their physicians have staff privileges at ten of the sixteen hospitals located in the Denver metro region. Because many of the PCPs and specialists contract with both PPP and CPP, PHP manages the delivery of care for almost 800 physicians in total. PHP currently negotiates capitated risk-based contracts with four Health Maintenance Organizations: Anthem Blue Cross and Blue Shield of Colorado, Secure Horizons, PacifiCare of Colorado Inc, KEY Primary Care Physicians (KEYPCP), and Oregon Department of Corrections (ODOC). PHP also holds three other contracts with government groups: the Colorado Department of Corrections (CDOC) and the Colorado Department of Youth Corrections (DYC). PHP provides services similar to those provided to CPP and CPP plus pharmacy management for DYC and claims administration for both. Through the three HMO contracts and the State contracts, PHP provides services for approximately 60,000 patients in the Denver Metro Region.
IPAs
CPP
Colorado Pediatric Partners, LLC (CPP) is a pediatric multi-specialty Independent Physician Association (IPA) comprised of Pediatricians and Pediatric Specialist physicians. These physicians are located throughout the greater Denver metro area. This IPA has been in existence since 2001. CPP elects a 9-member Board of Managers that meets regularly and includes both Pediatricians and Pediatric Specialist physicians.
Currently, CPP contracts for HMO risk-sharing business for commercial products. Utilizing the strength and advantages of the primary care model, PCPs (Pediatricians) coordinate care and refer patients needing specialist intervention to contracted specialists. CPP contracts with a large network of specialists to assure access to the broad scope of services their patients require. Also contracted are a variety of ancillary providers, including durable medical equipment, radiology, homecare, laboratory, and other outpatient services.
CPP contracts with Physician Health Partners (PHP) to provide IPA Management, Provider Relations, Contracting, Financial and Data Management, Utilization Management (utilization and case management) and the Practice Quality Program for clinical integration and practice development.
PPP
Primary Physician Partners, LLC (PPP) is a Primary Care Independent Physician Association (IPA) comprised of Family Practice, Internal Medicine, and Geriatric physicians. These physicians are located mainly in northwest Denver and contracting efforts steadily increase practice coverage across the Denver metro area. This IPA has been in existence since 1996, originally formed from Northern Health Partners and Superior Health Systems. PPP elects a 10-member Board of Directors that meets regularly.
Currently, PPP contracts for HMO risk-sharing business for both Medicare and commercial products. Leveraging the strength and advantages of the primary care model, PCPs coordinate care and refer patients needing specialist or ancillary (skilled nursing facility, inpatient, lab, x-ray, and other outpatient services) intervention to contracted specialists. PPP contracts with a large network of specialists to assure access to the scope of services their patients require. Also contracted are a variety of ancillary providers, including skilled nursing facilities, DME and laboratory.
PPP contracts with Physician Health Partners (PHP) to provide IPA Management, Provider Relations, Contracting, Financial and Data Management, Utilization Management (utilization and case management) and the Practice Quality Program for clinical integration and practice development.
SMPC
South Metro Primary Care (SMPC) is a Primary Care Independent Physician Association (IPA) comprised of Family Practice and Internal Medicine physicians. The physicians are located mainly in southwest Denver metropolitan area cities. This IPA has been in existence since August 2007. SMPC elects a 5-member Board of Directors that meets regularly.
SMPC contracts for HMO risk-sharing business for Medicare products. Utilizing the strength and advantages of the primary care model, PCPs coordinate care and refer patients needing specialist or ancillary (skilled nursing facility, inpatient, lab, x-ray, other outpatient services) services to contracted providers. SMPC contracts with a network of physician specialists to assure access to the scope of services their patients require. Also contracted are a variety of ancillary providers, including skilled nursing facilities, DME/oxygen and diagnostic imaging.
SMPC contracts with Physician Health Partners (PHP) to provide IPA management, provider relations, provider and health plan contracting, financial management, data management, utilization management and patient case management.
KEYPCP
KEY Primary Care Physicians (KEYPCP) is an Independent Practice Association (IPA) comprised of Internal Medicine and Family Practice physicians from the east and south metropolitan Denver area. Organizing in early 2008, our physicians are committed to providing quality care to their patients. Member physicians strive to continually improve health care delivery.
Statewide Government Contracts
Colorado Department of Corrections (CDOC)
PHP was awarded a five-year contract to be the healthcare administrator for Colorado Department of Corrections (CDOC) starting September 1, 2005. CDOC and PHP share the belief that delivering appropriate care in an effective manner can result in decreased cost while providing quality healthcare services. This common goal is central to our partnership and will influence our future direction together.
The primary care provider is the foundation of the care model used by CDOC & PHP. Based at each of the correctional facilities, CDOC primary care providers have the training to deliver a broad spectrum of care and are in the best position to know each offender’s medical history and needs.
When specialized care is required, the PCP refers the offender to qualified specialty care providers belonging to a network of trusted professionals who share our values and commitment to excellent healthcare.
Even when referred for specialty care, offender treatment continues to be guided, managed and monitored by their primary care provider.
Division of Youth Corrections (DYC)
The State of Colorado Department of Human Services, Office of Children, Youth, and Family Services, Division of Youth Corrections (DYC) awarded the five year healthcare administrator contract for the youth offenders in Colorado to PHP that began on July 1, 2006.
DYC youth have access to primary care services at each of the juvenile facilities. PHP coordinates with the primary care physicians to provide referrals for specialty care, pharmacy and dental services.
PHP has created a statewide provider network for DYC. The providers in this network have expertise in delivering care to this unique population.
Mental Health Institutes (MHI)
The State of Colorado Department of Human Services selected Physician Health Partners to manage healthcare services for psychiatric patients at the State’s Mental Health Institute (MHI) at Fort Logan. PHP works with MHI to provide access to care for patients who are in need of medical care outside of the Institute.
Through this contract, PHP provides MHI with a contracted provider network, utilization management, on-site case management, claims administration and data analysis.
Oregon Department of Corrections (ODOC)
The Oregon Department of Corrections (ODOC) awarded a six-year contract to Correctional Health Partners (CHP) starting July 1, 2009 to perform third party administrator (TPA) functions including establishing the external healthcare delivery network for ODOC inmates; and providing medical management, and claims payment services.
CHP will also provide clinical services to ODOC and providers that facilitate effective communication, more efficient care transitions between ODOC facilities and providers, and enhance the referral process. CHP nurses and other staff will coordinate care between network providers and ODOC facility medical providers.
CHP has contracted with First Choice Health Network (FCHN) to be its preferred provider network (PPO). FCHN will coordinate with CHP staff to resolve any outstanding issues providers may have. CHP is responsible for all claims payment and authorization issues. Together, FCHN and CHP are committed to making this a mutually beneficial experience between ODOC and its valued provider network. You may contact FCHN at their toll-free number, 877-287-2922, or 503-786-4697.