The native Valley Well being Alliance is a helpful participant in bringing open market medical insurance prices down within the Roaring Fork Valley and Garfield County.
However a second, member-based alliance that county commissioners have been wooing for the previous two years might punch these prices down even additional.
That was the pitch from Claire Brockbank, CEO of Summit County-based Peak Well being Alliance, throughout a web-based neighborhood discussion board hosted by the Garfield County commissioners Monday night.
Garfield County has been working with Peak to doubtlessly deliver its negotiated-pricing strategy to the county, working with well being care suppliers and insurers on an agreed charge schedule and insurance coverage charges.
Peak is a regionally managed, member-owned alliance that has been profitable in bringing extra aggressive insurance coverage costs to the Colorado counties it serves, Brockbank stated.
This yr, insurance coverage premiums went down as a lot as 40% in among the newer counties served by Peak in southwest Colorado.
The identical could possibly be true for Garfield County, she stated, and it doesn’t need to be an “both/or” proposition.
“We really feel just like the residents of Garfield shouldn’t have to attend and see (if prices proceed to return completed underneath the 2 carriers now serving the realm, Anthem and United Well being Care/Rocky Mountain Well being Plans),” she stated. “That doesn’t really feel wholesome for the neighborhood. …Let good old style essential road competitors work.”
A 3rd provider is ready to enter the market underneath Peak, Brockbank stated, however loads rides on bringing a key participant to the desk — Valley View Hospital.
At present, Valley View has indicated that it’s comfy persevering with to work with the Valley Well being Alliance partnership in Garfield and Pitkin counties to deliver prices down and supply extra insurance coverage choices.
Valley Well being Alliance CEO Chris McDowell additionally spoke through the Monday discussion board. He touted the alliance’s work with the three space hospitals — Valley View, Aspen Valley and Grand River Well being in Rifle — working with Rocky Mountain Well being Plans to deliver extra aggressive insurance coverage charges to shoppers.
Along with the three hospitals, the alliance contains the Aspen Snowboarding Firm, Pitkin County, town of Aspen, Mountain Household Well being Facilities, and the chambers of commerce from Aspen to western Garfield County.
“The muse of our work is major care,” McDowell stated of the alliance’s give attention to up-front preventative care and bringing prices down by means of built-in care between the assorted suppliers.
“The important thing was bringing all three hospitals collectively,” he stated. “It’s all clinically pushed … which brings us to raised affordability.
“We’re constructing slowly and steadily, however we’re actually beginning to see a profit to the neighborhood,” McDowell stated.
That stated, “There’s extra to be completed, and that is simply step one. We actually need to assist cut back the price of care, however that’s not one thing we will pressure on anyone.”
Each approaches have served to scale back prices.
About 7,000 folks in Garfield County are actually being served by Rocky Mountain Well being Plans, which introduced a mean 15% discount in premiums for 2021 in comparison with Anthem, the opposite provider serving the realm by means of Join for Well being Colorado, McDowell stated.
Peak Well being Alliance would be capable to deliver much more aggressive charges, Brockbank stated.
She estimated a mid-level “silver” insurance coverage plan on the state change in Garfield County would value $283.55 by means of Peak’s efforts, in comparison with $523.23 for Anthem and $462.20 for Rocky Mountain Well being Plans.
“The information appears to point we could possibly be doing higher in Garfield County,” she stated.
McDowell stated it’s necessary in looking for medical insurance to look past premiums at co-pay necessities and deductibles.
“There are loads of nuances in well being care,” he stated. “I like all effort that’s transferring away from deductibles and co-pay, as a result of these are obstacles to care.
“We’ve got to determine the issues which are stopping folks from getting the care they want, once they want it,” McDowell stated.
Brockbank stated Peak might proceed in Garfield County with out Valley View Hospital within the supplier community, however together with Grand River, Mountain Household Well being and hospitals in Grand Junction and Denver for extra specialised care.
Nevertheless, that’s not a perfect community, particularly for residents of Glenwood Springs and Carbondale, she acknowledged.
“We don’t disagree that the Rocky Mountain Well being Plan is sweet, however we expect we will do higher,” Brockbank stated.
Additionally talking through the discussion board was state Sen. Bob Rankin relating to his efforts across the state’s reinsurance program to assist folks cowl prices of catastrophic care, and the assorted items of laws at present being debated within the Colorado Legislature.
A type of is the general public possibility proposal that may require insurance coverage carriers to scale back charges by 20% in two years, or a state-funded public possibility could be created.
“I’m extraordinarily skeptical about whether or not that may actually work, or not,” Rankin stated. “I feel we might lose carriers, hospitals and docs if we did that.”
Different laws would sort out prescription drug prices and require extra transparency from hospitals and different suppliers relating to the price of care.
Rankin stated the most important change could possibly be the modifications to the federal Reasonably priced Care Act that got here with the latest passage of the American Restoration Plan. It removes the poverty stage cap to qualify for Medicaid, and as an alternative permits folks to qualify if their insurance coverage premiums exceed 8% of their revenue.
“I don’t see any motion on the state stage that’s going to assist with the (value) disparity between rural Colorado and the Entrance Vary, which continues to be a difficulty,” Rankin stated. “These modifications on the federal stage is likely to be extra impactful.”
Senior Reporter/Managing Editor John Stroud will be reached at 970-384-9160 or email@example.com.