Centura Health backs out of Southwest Colorado community health alliance
FRISCO — Centura Health, the largest health care provider in Colorado and owner of St. Anthony Summit Medical Center, has backed out of participating in a community health care alliance in southwest Colorado and instead will offer its own discounted plan that promises 20% savings from previous offerings.
Centura made the announcement with a paid advertisement in the most recent weekend edition of The Durango Herald. The move effectively means Centura is dropping out of negotiations to collaborate with Southwest Health Alliance, an offshoot of Summit County’s Peak Health Alliance operating under Peak’s guidance, to negotiate rates with insurers and provide plans directly to consumers.
Centura owns and operates Mercy Regional Medical Center, one of Durango and southwest Colorado’s largest and most technologically advanced hospitals. In a news release announcing the departure from negotiations, Centura officials said there was no single solution that worked for all Colorado communities.
“Real solutions don’t come in third-party packages,” the Centura advertisement said. “We learned some valuable lessons last year in Summit County.”
The ad went on to subtly criticize the intermediary negotiation model on which Peak Health is based.
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“When Centura offers major price discounts, it doesn’t always correspondingly translate to reductions in insurance premiums for individuals and businesses,” the ad states. “These third-party ‘solutions’ can also significantly and unnecessarily narrow consumers’ choices for health care while completely eliminating necessary competition in the marketplace.”
While the move in Durango has no immediate impact in Summit, where Centura has a commitment with Peak Health through next year, it does have Peak Health worried that the health provider might use the same tactic in Summit during next year’s negotiations, making its own agreements with insurance carriers and offering its own discounted health plan while cutting Peak Health and the broader community out of the process.
Peak Health CEO Tamara Pogue said she is concerned about how Centura went about the split, saying Southwest Health Alliance had been working with Centura for three months on a deal and that the announcement came at the last minute, just when the state would require Southwest Health Alliance to submit its rates for 2021 approval.
“They were aware we would have to have the fee negotiations and rate schedules wrapped up this week,” Pogue said. “They made the decision seemingly last minute and didn’t give us many options moving forward. I have to tell you that the folks down there (at Southwest Health Alliance) are very angry about this lack of transparency and accountability in the system.”
Pogue said she believes state politics — particularly the push by Gov. Jared Polis’ administration to introduce a public health insurance option in the state — had a part to play in Centura’s departure from negotiations with Southwest Health Alliance.
“They made these deals behind closed doors that don’t create transparency or empower communities,” Pogue said. “I believe (Centura) has a significant amount of anger at the Polis administration on the public option proposals and they are using this maneuver to express their feelings. Publicly, Centura has been so supportive of the community alliance model, and that makes this seem completely out of character.”
Monique DiGiorgio is director of the Local First Foundation, a Durango-based community foundation instrumental in building the Southwest Health Alliance. She said her group was “blindsided” by Centura’s decision.
“It’s hard to believe that they came to the negotiating table with us in good faith,” DiGiorgio said. “It seemed to epitomize what’s missing from health care in general, which is truth, transparency and honesty.”
DiGiorgio said she and others with the Southwest Health Alliance were “appalled” by the way Centura conducted negotiations. She had choice words directed toward the health care giant and Mercy Regional Medical Center, where Southwest Health Alliance supporters planned to protest during a Tuesday forum Centura was conducting with hospital doctors and staff.
“First, shame on you for calling yourself a community hospital when you take orders from Centura’s corporate offices and take the community out of the picture,” DiGiorgio said. “Second, we think you really made the wrong decision. We do applaud taking 20% off of prices, which remains to be seen, but you should also be staying at the table with Southwest Health Alliance for the next two days.”
DiGiorgio said she remained optimistic Centura leaders would change their minds and return to the negotiating table. In the meantime, she said the alliance will continue negotiations with other providers in the area, including the regional anchor hospital, Animas Surgical Hospital.
As far as Summit, Pogue said she fears Centura will do the same thing in Summit next year or in the years to come, creating its own deals with carriers like Rocky Mountain Health Plans and Bright Health while cutting Peak Health Alliance out of the picture.
Pogue admitted Centura has expressed its continued commitment to Peak Health in Summit. She also said the fact that only 13% of St. Anthony’s business comes from locals makes it less likely that Centura would back out of Peak health in favor of its own plan because business would continue to roll in.
Centura Director of Communications Wendy Forbes provided a statement from Centura that aimed to tamp down concerns Centura would pull out of Peak Health in the coming years, saying Centura was committed to innovative solutions that fit best for individual communities.
“Centura Health and St. Anthony Summit Medical Center are committed to our partnership with Peak Health Alliance in Summit County which spans through 2020 and 2021,” the statement said. “We were the first and are still the only Peak partner in the state of Colorado. We will always support real, viable, and sustainable solutions that put savings directly into the pockets of our neighbors.”