Summit County’s innovative Peak Health Alliance on track to launch in 2020
Architects of Summit County’s innovative Peak Health Alliance venture continued their push to inform the community on the nuts and bolts of the health care collaborative during Summit Daily’s “What’s Brewing” forum on health care Thursday morning at the Summit County Community and Senior Center in Frisco.
Family and Intercultural Resource Center executive director Tamara Drangstveit and Summit Foundation board president Mark Spiers were on hand to explain the progress on the Peak Health Alliance and answer questions from a small group of community residents eager to learn more about the initiative that is being billed as a potential, serious long-term fix to high health care costs in the mountains.
Drangstveit joked that she and the group that has been building the alliance are essentially “rodeo clowns” trying to wrangle with a first-of-its-kind project in Colorado. However, she said they had learned much about health care in the process and that education provided a clear-cut mission: lower cost of treatment.
In pinpointing health care and provider costs as the main catalyst for high insurance rates, the alliance will focus its efforts on bringing the price of care down. To do that, bargaining is the key tool. The founders of the alliance were able to determine that individuals have very limited purchasing power on their own, and even businesses that thought they were getting a good deal by bringing more “lives” to the negotiating table were found to be paying much more than they needed to compared to their Front Range counterparts.
This brought about the idea to bring the county’s largest employers together into one negotiating entity. More lives equals more customers potentially gained or lost for a provider and for an insurer. By negotiating prices for different products and billable services, the group can also bring better rates for Summit County customers.
New details that emerged at the forum included the fact that there will be several options with the alliance plan, showing very little change from what consumers see on the regular health care marketplace each year. Health savings account plans will remain, and alliance members will have the option to pay a lower premium for a narrower network of providers, or more for a wider network. It’s their choice — a key selling point for folks who are worried about being stuck in a one-size-fits-all plan.
There are some significant hurdles remaining, however. The alliance has until April to negotiate a price rate list with providers that they can then bid out to insurers. When it comes to the area’s largest hospital, St. Anthony Summit Medical Center, which is owned by Centennial-based Centura Health, there is no guarantee for being able to strike a better deal on prices, which currently generate profit margins of up to 30 percent.
“We as a community have to decide what we think is a fair amount of profit,” Drangstveit said.
By declining to collaborate with the Peak Health Alliance, business could go on as usual in Colorado with providers and insurers continuing to profit while consumers shoulder health costs that, in Summit County’s case, eat up 40 percent of some family budgets.
These are all issues that the Peak Health Alliance’s founders are taking into consideration. Drangstveit and Spiers warned of the prospect of Centura Health balking at cutting prices and therefore forcing the alliance to work only with providers who are on the Front Range. That would mean that Summit residents would be unable to get treatment at the biggest hospital in their own backyard, at least not without going out-of-network.
However, Drangstveit and Spiers noted that half of the employees working at Summit’s largest employers already go to the Front Range for health care.
They also noted that the number of lives the alliance brings to the table — estimated to be 7,500 coming from employers including the county government, the towns of Breckenridge and Silverthorne, the school district, Breckenridge Grand Vacations and elsewhere — is a high number of year-round patients to lose. And that number is expected to increase once small businesses and individuals are able to come on board.
One way or the other, the Peak Health Alliance is still on track to launch in January 2020, and the Alliance’s founders have promised to keep the community updated on significant developments, including when a price rate list is drawn up and put out for bids from insurers.
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