CO-EARTH (COlorado is Expanding Access to Rural Team-based Healthcare) is a collaborative effort between St. Mary’s Family Medicine Residency, Rocky Mountain Health Plans, the Caring for Colorado Foundation, and the University of Colorado Department of Family Medicine. Any Western Colorado primary care office from a rural community or a smaller office (one to six providers) from a larger community is eligible to apply. System- and independently owned practices are welcome. 

Colorado is at the cutting edge of behavioral health integration, with many health care systems boasting advanced, high functioning integrated models. Our state also benefits from a four- year federal grant (the State Innovation Model) that aims to expand integrated behavioral health services to the primary care offices of 80% of Coloradans. CO-EARTH’s sponsors aim to ensure that these benefits are relevant and accessible to all types of practices, with a specific emphasis on assisting smaller practices or those from rural communities.

CO-EARTH offers three levels of training and support uniquely tailored to the needs of participating clinics and communities:

  • Coordinated Care Track: For clinics wanting to improve their existing staff’s ability to address behavioral health issues and to collaborate with behavioral health clinicians in the community (three to four months for completion)
  • Co-Located Care Track: For clinics wanting to embed a behavioral health clinician (six to eight months for completion)
  • Integrated Care Track: For clinics who already embed behavioral health clinicians and now want to create a fully integrated model—clinical services, payment, documentation and leadership (12+ months for completion).

The CO-EARTH team works with your clinic to identify strengths, resources and a vision for practice transformation. Our services will include a one-day training visit, monthly support phone calls, and a one-day multi-site learning collaborative. Additional services can include one- to three-week rural rotations with family medicine residents trained in integrated care and assistance in applying for the State Innovation Model (SIM) program.

There is no cost to participate, but we will require monthly participation in a conference call from all involved clinicians and staff.

Program Objectives (vary between tracks):

  1. Screening and tracking psychiatric conditions in primary care
  2. Primary care counseling and behavioral intervention skills
  3. Basics of coordinated care
  4. Basics of co-location
  5. Basics of integration
  6. Care management
  7. Business practices
  8. Human resources and leadership
  9. Health information technology (HIT)
  10. Quality improvement (QI) and change management 

Practice Deliverables:

  1. Initial self-assessment upon entrance into the program
  2. Attendance at an annual CO-EARTH learning collaborative, usually in June
  3. Monthly internal QI meetings pertaining to CO-EARTH work
  4. Monthly team conference calls with St. Mary’s and RMHP Quality Improvement Advisor
  5. Narrative to summarize progress and plans for continued growth upon completion of the program

Co-Earth & Sim Portal ›


The Colorado State Innovation Model (SIM) is an initiative funded by the Center for Medicare & Medicaid Services (CMS). The goal is to improve the health of Coloradans by increasing access to integrated physical and behavioral healthcare services in coordinated systems and encouraging SIM practices to test value-based payment structures. The SIM Initiative will have three cohorts over five years, reaching up to 400 primary care practices and four community mental health centers. The SIM program strives to influence the healthcare of 80% of Colorado residents through its efforts, which include collaboration with regional health connectors and local public health agencies, by 2019.

To achieve this goal, SIM will select primary care practice sites from across the state to receive practice transformation support to help them integrate behavioral health and primary care and facilitate a transition to value-based payments. Success in this value-based reimbursement world requires different skills and processes that allow providers to integrate behavioral health and primary care. The SIM Initiative helps guide practice sites along this path with intensive coaching to implement integrated care and turn data into actionable information that helps build sustainable models. To date, seven public and private payers have signed a Memorandum of Understanding (MOU) with the SIM Office, in which they have committed to work collaboratively with SIM to transform the way primary care and behavioral healthcare is delivered and financially support practice sites selected for participation in SIM within their networks.

Visit  or the State website  for more information about the SIM program.

Co-Earth & SIM Portal ›


To learn more, contact us.