Giving Thought: Competition comes to the region’s health-insurance market

The high cost of living in the Roaring Fork Valley is one of the factors that makes our population perpetually restless and transient.

Prices are often prohibitive for things like rent to gasoline in the Aspen-to-Parachute region, but one of the biggest costs is health care and health insurance. Fortunately, there is some good news to report on this front. Two new health insurance companies are offering policies to valley residents in the small group category (small businesses and nonprofits) and the individual market.

Anthem Blue Cross Blue Shield has been the only choice for individuals and small employers for several years, but United Healthcare, the small group insurer, and Rocky Mountain Health Plans, the individual provider, are now offering policies at 5% to 15% cheaper rates.

While this won’t solve all our region’s cost-of-living issues, it is a here-and-now improvement that has the potential to grow over time. The Valley Health Alliance is the entity to thank for these changes in our health care landscape, and Chris McDowell, the organization’s executive director, has been working for years to bring the valley’s employers and health care providers together on the problem.

“The only time you’ll see the needle move in health care is with a strong partnership between employers and providers,” said McDowell, who is taking the long view and seeking a systemic change in the health care marketplace.

The Alliance’s purpose is to “promote the health and well-being of our communities by providing health care that is accessible, affordable and high quality.” That mission statement rests on a real-world design that starts with primary-care doctors. When patients have a relationship with a primary-care physician, they become personally invested in their own health, they have a go-to person to answer health-related questions and they tend to avoid costly visits to the hospital emergency room.

“The more people we have engaged in primary care, the less expensive health care becomes,” McDowell said.

Between 7,000 and 10,000 lives have already felt the impact of this clinically integrated network, McDowell added, and most of the valley’s family doctors participate. That’s 265 health care providers if you include individual doctors, nurses, physician assistants and other medical staff.

The Alliance includes a roster of local organizations and employers, including the Aspen Skiing Co., Pitkin County, the city of Aspen, Mountain Family Health Centers in Glenwood Springs, Aspen Valley Hospital, Valley View Hospital, Grand River Health Centers and five chambers of commerce in Aspen, Basalt, Carbondale, Glenwood and Western Garfield County.

Jake Mascotte calls VHA one of “the most underappreciated and undervalued resources in the valley,” because most valley residents are unaware of the Alliance’s work. A former insurance industry executive and a member of the Aspen Community Foundation’s board of directors, Mascotte says the full benefit of the emerging regional network won’t be apparent for about five years, when the data collected by the network’s providers and employers slowly reveals the overall impact on patient outcomes and health care costs.

“Over time, this should provide better care and lower costs,” Mascotte said.

Other features of the new system, which follows a model from the Community Care Alliance in Grand Junction, include a monthly fee that is paid to primary-care practices for every patient they serve. This gives doctors an incentive to improve each patient’s outcomes. Also, doctors are able to focus on patient care because their practices have hired “care coordinators” to help patients with chronic health issues to schedule appointments and navigate the health care system. This helps the front-line medical staff to do what they’re trained for, while handing off administrative tasks to a dedicated person.

The Alliance believes this emerging “ecosystem” has the potential to change health care in the Aspen-to-Parachute region for the better. If you’d like to check out some of the new insurance offerings, go to the Connect for Health Colorado website,and click the “compare plans” link.

Tamara Tormohlen is executive director of Aspen Community Foundation.