Could Peak Health be next step in bringing Garfield County health insurance costs down?
Panelists offer merits of regional approach, existing Valley Health Alliance; hospitals hold key decisions
The local Valley Health Alliance is a valuable player in bringing open market health insurance costs down in the Roaring Fork Valley and Garfield County.
But a second, member-based alliance that county commissioners have been wooing for the past two years could punch those costs down even further.
That was the pitch from Claire Brockbank, CEO of Summit County-based Peak Health Alliance, during an online community forum hosted by the Garfield County commissioners Monday evening.
Garfield County has been working with Peak to potentially bring its negotiated-pricing approach to the county, working with health care providers and insurers on an agreed fee schedule and insurance rates.
Peak is a locally managed, member-owned alliance that has been successful in bringing more competitive insurance prices to the Colorado counties it serves, Brockbank said.
This year, insurance premiums went down as much as 40% in some of the newer counties served by Peak in southwest Colorado.
The same could be true for Garfield County, she said, and it doesn’t have to be an “either/or” proposition.
“We feel like the residents of Garfield shouldn’t have to wait and see (if costs continue to come done under the two carriers now serving the area, Anthem and United Health Care/Rocky Mountain Health Plans),” she said. “That doesn’t feel healthy for the community. …Let good old-fashioned main street competition work.”
A third carrier is prepared to enter the market under Peak, Brockbank said, but a lot rides on bringing a key player to the table — Valley View Hospital.
Currently, Valley View has indicated that it’s comfortable continuing to work with the Valley Health Alliance partnership in Garfield and Pitkin counties to bring costs down and provide more insurance options.
Valley Health Alliance CEO Chris McDowell also spoke during the Monday forum. He touted the alliance’s work with the three area hospitals — Valley View, Aspen Valley and Grand River Health in Rifle — working with Rocky Mountain Health Plans to bring more competitive insurance rates to consumers.
In addition to the three hospitals, the alliance includes the Aspen Skiing Company, Pitkin County, the city of Aspen, Mountain Family Health Centers, and the chambers of commerce from Aspen to western Garfield County.
“The foundation of our work is primary care,” McDowell said of the alliance’s focus on up-front preventative care and bringing costs down through integrated care between the various providers.
“The key was bringing all three hospitals together,” he said. “It’s all clinically driven … which brings us to better affordability.
“We are building slowly and steadily, but we are really starting to see a benefit to the community,” McDowell said.
That said, “There is more to be done, and this is just the first step. We really want to help reduce the cost of care, but that’s not something we can force on anybody.”
Both approaches have served to reduce costs.
About 7,000 people in Garfield County are now being served by Rocky Mountain Health Plans, which brought an average 15% reduction in premiums for 2021 compared to Anthem, the other carrier serving the area through Connect for Health Colorado, McDowell said.
Peak Health Alliance would be able to bring even more competitive rates, Brockbank said.
She estimated a mid-level “silver” insurance plan on the state exchange in Garfield County would cost $283.55 through Peak’s efforts, compared to $523.23 for Anthem and $462.20 for Rocky Mountain Health Plans.
“The data seems to indicate we could be doing better in Garfield County,” she said.
McDowell said it’s important in shopping for health insurance to look beyond premiums at co-pay requirements and deductibles.
“There are a lot of nuances in health care,” he said. “I like any effort that is moving away from deductibles and co-pay, because those are obstacles to care.
“We have to figure out the things that are preventing people from getting the care they need, when they need it,” McDowell said.
Brockbank said Peak could proceed in Garfield County without Valley View Hospital in the provider network, but including Grand River, Mountain Family Health and hospitals in Grand Junction and Denver for more specialized care.
However, that’s not an ideal network, especially for residents of Glenwood Springs and Carbondale, she acknowledged.
“We don’t disagree that the Rocky Mountain Health Plan is good, but we think we can do better,” Brockbank said.
Also speaking during the forum was state Sen. Bob Rankin regarding his efforts around the state’s reinsurance program to help people cover costs of catastrophic care, and the various pieces of legislation currently being debated in the Colorado Legislature.
One of those is the public option proposal that would require insurance carriers to reduce rates by 20% in two years, or a state-funded public option would be created.
“I’m extremely skeptical about whether that would really work, or not,” Rankin said. “I think we would lose carriers, hospitals and doctors if we did that.”
Other legislation would tackle prescription drug costs and require more transparency from hospitals and other providers regarding the cost of care.
Rankin said the biggest change could be the changes to the federal Affordable Care Act that came with the recent passage of the American Recovery Plan. It removes the poverty level cap to qualify for Medicaid, and instead allows people to qualify if their insurance premiums exceed 8% of their income.
“I don’t see any action at the state level that’s going to help with the (cost) disparity between rural Colorado and the Front Range, which is still an issue,” Rankin said. “These changes at the federal level might be more impactful.”
Senior Reporter/Managing Editor John Stroud can be reached at 970-384-9160 or firstname.lastname@example.org.
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