Kaiser Permanente leaving Eagle, Summit counties | VailDaily.com

Kaiser Permanente leaving Eagle, Summit counties

Healthcare/insurance company ends four-year foray into the High Country

In 2015 Kaiser Permanente Colorado's Brent Bowman said the healthcare/health insurance company was making a 10-year commitment to Eagle and Summit counties. Kaiser confirmed Thursday that they're pulling out of Eagle and Summit counties at the end of the year.
Daily file photo

VAIL – Colorado’s High Country will have one less health insurance and healthcare option by the end of the year.

Kaiser Permanente Colorado is pulling out of Eagle and Summit counties, the health care provider confirmed Thursday afternoon.

Kaiser partially blamed hospitals in Eagle and Summit counties, saying they have been “unreasonably opposed to contracting with us,” a marked shift from the 10-year commitment Kaiser made four years ago when it said those contracts might not matter. Kaiser also pointed fingers at Front Range hospitals for its troubles there. The Colorado Hospital Association countered that Kaiser is responsible for its own problems.

“Kaiser Permanente Colorado began serving the mountain communities nearly four years ago with the goal of increasing access to high-quality, affordable health care,” Amy L. Whited, director of communications, community health and engagement for Kaiser Permanente Colorado said in a statement. “Unfortunately, we have been a very small player in a challenging market, and hospitals in the community have been unreasonably opposed to contracting with us.”

The local hospitals are St. Anthony’s Summit Medical Center in Frisco and Vail Health Hospital.

“We were surprised to hear the news,” said Michael Holton with Vail Health. “Our goal is to provide the highest quality of care close to home.”

Without hospital contracts, Kaiser has not been able to secure a “sustainable level of membership,” Whited said.

Kaiser serves approximately 4,400 members in Summit and Eagle counties, less than 5 percent of the Eagle/Summit County market and less than 1 percent of Kaiser’s total membership in Colorado, Whited said.

“We are committed to minimizing the disruption for our members and assisting with the transition of their care and coverage,” Whited said.

’10-year proposition’

Ironically, Brent Bowman, Kaiser’s executive director for regional strategy said four years ago when the company entered opened in Eagle and Summit counties that, while not having a hospital contract would be a challenge, Kaiser was in it for the long haul.

“We have to commit to a 10-year proposition,” Bowman said at the time.

Kaiser’s four-year foray into Colorado’s resort region ends when it closes the Edwards and Frisco offices on Dec. 27.

Kaiser’s troubles are not limited to the High Country. Colorado’s largest health insurer laid off  400 people over the past eight months.

Kaiser’s High Country conundrum

Part of Kaiser’s High Country conundrum is competition or the lack of it, explained Bethe Wright of the Wright Insurance Co.

In Denver, and along Colorado’s more densely populated Front Range, health insurance providers can negotiate with hospitals and doctors for discounts as high as 50% on some procedures. In the High Country, that discount rarely tops 10 percent, numbers that are readily available from a patient’s billing statement, Wright said.

Besides opening medical clinics in Edwards and Frisco, Kaiser was among the first to offer online access to doctors. Kaiser had even offered to transport patients to Denver for medical procedures at a Kaiser facility, put them in a hotel and bring them home – if it was less expensive than the procedure would cost locally, a business method Kaiser has used successfully in other places.

And the good news is …

The good news is that this year’s state legislation might provide some relief in 2020.

The Vail Symposium and Vail Valley Partnership co-hosted a Vail Valley Business Forum on Thursday morning, “Healing What Ails Us … Affordable Healthcare In Our Community.” In the hour-and-a-half forum, healthcare executives and elected officials discussed how the private and public sectors are tackling the issue of skyrocketing healthcare and health insurance costs.

In Summit County, the Peak Health Alliance is scheduled to roll out next year and could mean health insurance rates drop by 20%.

Vail Health CEO Will Cook said the hospital and other Eagle County entities are working to roll out some solutions in 2021.

In the meantime the Vail Valley Partnership rolled out its One Valley Healthcare Program late last year. It’s not insurance, but covers preventive care and other options for employers, employees and sole-proprietors who are VVP members.

Kaiser’s departure leaves Anthem/Blue Cross as the only individual health insurance carrier left in Eagle County, while Summit also has Bright Health in addition to Anthem.