New effort aims to lower Eagle County’s health insurance costs | VailDaily.com

New effort aims to lower Eagle County’s health insurance costs

Mountain Healthcare Coalition seeks to emulate Summit County co-op effort

Colorado Gov. Jared Polis smiles in May after signing a bill alongside Sen. Kerry Donovan, Lt. Gov. Dianne Primavera and Rep. Dylan Roberts outside of Blue Moose Pizza in Lionshead Village. Donovan and Roberts sponsored legislation this past session that aims to decrease the cost of health insurance for mountain residents, including a law that helps communities emulate Summit County's Peak Health Alliance model.
Chris Dillmann | cdillmann@vaildaily.com

VAIL — Gov. Jared Polis has lauded Summit County’s health care purchasing collaborative as a “transformative” step toward lowering the cost of health care.

Officials in Eagle County are now hoping they can adopt a similar model for residents here.

The Vail Valley Partnership, a local nonprofit that acts as a regional chamber of commerce and advocates for the Vail Valley’s economic health, is working with Vail Health and other stakeholders to develop the Mountain Healthcare Coalition as a nonprofit health care purchasing collaborative for Eagle County.

It aims to help lower health care costs for individuals and both insured and self-insured companies.

“The idea is, how do we bring together all the different sectors, being self-insured groups, large group markets, small group markets, and the individual market to aggregate and to have a bigger pool to be able to work with Vail Health to lower prices and increase local utilization,” said Chris Romer, president and CEO of the Vail Valley Partnership.

In Eagle County, 16.9% of residents are uninsured, according to the Colorado Health Institute. Statewide, that number is 8.2%, according to the group.

How does it work?

The Summit County program, Peak Health Alliance, was officially launched earlier this month as the state’s first health care purchasing collaborative. That program, in tandem with the state’s new reinsurance program, promises to reduce individual plan prices in Summit County by an average of 41.5% next year.

How does it work? On behalf of its bloc of customers, Peak Health Alliance negotiates with health care providers for lower prices on various services. Peak Health Alliance then presents its negotiated price sheet to insurance carriers, which can bid on being the carrier.

Earlier this year, Peak negotiated a price sheet with Centura Health, and then chose Rocky Mountain Health Plans as the carrier for group plans and Bright Health as the individual insurance carrier.

Romer isn’t sure if the Eagle County program will be structured exactly the same way as the one in Summit County. He said it could be more “organic” and “collaborative,” since there are more players at the table early in the process.

First and foremost, that includes Vail Health, the county’s dominant health care provider.

“There they are fully at the table and they recognize the issue,” Romer said. “Will Cook, their CEO, has been leading the charge with them and their team and working with us. I can’t say enough about his engagement and sense of collaboration.”

Watching carefully

Cook said Vail Health is supportive of the health purchasing collaborative — as well as other initiatives that could help reduce the cost of health care for locals.

“A lot of different things, because it’s going to require a lot of solutions, not just one silver bullet,” he said.

Cook said he’s watching Peak Health Alliance carefully as it moves toward offering plans in 2020.

“We commend and applaud them,” he said. “They were the first. The beauty of being the second is you can take the bulk of what was good and emulate it and look for things that are better and suit you favorably and learn from it.”

The Vail Valley Partnership and Vail Health are now examining data about where local residents are getting their health care, as well as local costs compared to Garfield County, Summit County, the Denver metro area and the rest of Colorado, Romer said.

Romer said the Mountain Healthcare Alliance is hoping to launch in 2021.

There are only two insurance companies on the Affordable Care Act exchange in the Eagle County market — Kaiser Permanente and Anthem Blue Cross Blue Shield. Kaiser plans to leave Eagle and Summit counties by the end of the year, the company said in June.

The Partnership also offers the One Valley Healthcare Program, which is not insurance, but it is an alternative that offers preventative care and medical cost-sharing. Romer said it has been popular among businesses and individuals.

Matt Scherr, an Eagle County commissioner, said he’s glad that Eagle County is pursuing the purchasing collaborative model, but he is also taking a wait-and-see approach.

“It’s a good idea to pursue,” he said. “But anything that’s an idea has to be tested before we know whether it’s a good idea.”

Vince Plymell, assistant commissioner of the Colorado Division of Insurance, said his agency is very interested in working with communities to help spread the co-op model. In fact, the state’s insurance commissioner, Michael Conway, helped introduce the idea to the state, Plymell said.

“There is room for this to work in all corners of Colorado,” Plymell said.

Statewide efforts

Eagle County’s representatives at the state Capitol, Sen. Kerry Donovan and Rep. Dylan Roberts, have been active in advancing health care solutions.

A bill co-sponsored by Donovan and Roberts helped create a framework for efforts such as the Peak Health Alliance. It cleaned up language in the state’s laws to make it easier for other communities to emulate the purchasing collaborative model.

“I think it could be very significant for folks,” Donovan said of the Eagle County effort. “It takes the impossibility of negotiating as a customer of one and brings together a larger group to have the power of larger numbers in order to work toward better deals.”

Donovan and Roberts also co-sponsored a bill that creates a framework to create a publicly funded health insurance option for residents in mountain and rural counties. State agencies are still working to create a draft proposal for the public option.

Donovan also sponsored legislation to create the reinsurance program, which will allow health insurance premiums for plans purchased on the individual market to drop by 18% statewide and over 29% in mountain areas.

“That’s what my goal has been with sponsoring these bills — people in Eagle County and people across Western Colorado need more options and lower prices,” Roberts said. “More competition means lower prices. I’m excited that all of these things are working together to hopefully result in lower prices and more access for people.”