Valley health plan is still an elusive dream |

Valley health plan is still an elusive dream

Janet Urquhart

Remember the Roaring Fork Valley Community Health Plan?

It made a lot of headlines five years ago, when a contingent of medical and business community representatives stepped up with an ambitious plan to tackle a daunting range of health insurance woes. They envisioned a ground-breaking approach to insurance that would make affordable health insurance available in a valley where premium costs were skyrocketing, reimbursements weren’t covering providers’ costs and a worrisome number of local residents had no insurance at all.

The idea was to bond physicians, patients and employers together to present a united front to an insurance carrier and come away with a plan that gave the valley a say in the price of health insurance and the types of services covered. The Community Health Plan was to be locally based. The organizers sought a licensed insurer to provide a plan that could be purchased through local brokers.

It had never been done before. It still hasn’t. Today, employers are grappling with huge increases in health insurance costs (see related story), and a segment of the valley’s population is still without health insurance.

“It’s especially disturbing to us because to package and offer a health insurance program for our members has been a goal for years,” said Christine Nolen, president of the Aspen Chamber Resort Association and a member of the Community Health Plan board. “It’s very difficult for us to even talk to an interested insurance partner.”

At a forum last month which brought together the state insurance commissioner and other industry representatives, Nolen asked what the chamber’s chances of offering a health insurance program for its members might be.

“Their answer was `slim to none,’ which was very discouraging,” she said.

But Bill Hanisch, executive director of the Roaring Fork Valley Community Health Plan, hasn’t given up.

The Community Health Plan is in fact a functioning nonprofit corporation. It received a significant boost three years ago with a $500,000 federal grant from the Office of Rural Health Policy. The money, a three-year grant that is now running out, funded Hanisch’s position and the effort to establish a local insurance program.

Of 36 grant recipients nationally, the local program is one of 16 that still survives, Hanisch noted. The Community Health Plan has been recognized as a success story for the grant program, he said.

“We are self-sufficient and self-sustaining with what we’ve got now,” he said.

The Community Health Plan established and administrates self-funded health insurance programs for three large valley employers – the Aspen Skiing Co., Aspen Valley Hospital and Valley View Hospital.

While insurance costs for those clients can still jump – the Skico’s insurance costs are up 20 percent this year – the overhead of a large insurance company is not part of that cost. The Community Health Plan’s administrative costs are not driven by a profit motive, and its staffing is handled on a contract basis, not by full-time employees.

The increased costs the Skico is facing “are not nearly as high as what’s happening on the open market,” Hanisch added.

“I’m hearing from our members that their premiums are increasing by leaps and bounds,” Nolen confirmed. “I’ve heard everything from 30 percent to 100 percent.”

It’s those smaller employers struggling with staggering increases that need to be the Community Health Plan’s next clients, Hanisch stressed. In fact, Hanisch said he’s ready to step down as the program’s director if that is not its future goal.

The program’s board, including three chamber directors, the CEOs at the two local hospitals, four medical representatives, one Skico representative and two at-large members, is currently discussing where the Community Health Plan goes from here.

Hanisch wants to pursue the original vision for the Community Health Plan – an insurance package tailored to the valley and affordable to local employers and workers.

“We haven’t gotten to where we wanted to get with a plan for small employers yet,” he said.

Finding an insurance company to provide a program that fits with the valley’s philosophy and goals – that can be administered with local control – won’t be easy, Hanisch conceded.

“We have to secure an insurance partner that will work with our criteria,” he said. “We intend to maintain localized control of the plan. That’s where negotiations will be the most difficult.

“We’re trying to do something that is not being done elsewhere,” he said.

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Posted:Monday, October 30, 2000

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