Opinion | Conway: How the Peak Health Alliance will succeed
Lately, in these pages and around the Summit County community, many of you might have heard about the Peak Health Alliance and their new approach to health insurance. Peak Health is an outgrowth of work done over the last year and a half by leaders in the county who, like most of us, are fed up with high prices in health care and health insurance. They were fed up with the fact that there seemed to be no viable solutions. As Colorado’s insurance commissioner, I’ve been fortunate enough to work with this dedicated group of folks to bring forward a new idea.
Why Summit County?
In large part, I started working with Summit County because of the work already underway to find solutions to the health care conundrum that has beset rural and mountain counties in Colorado — health care prices spiraling out of control. The commitment of your Summit County leaders — Tamara Drangstveit, Sarah Vaine, Mark Spiers, Dan Gibbs, Thomas Davidson, Rep. Julie McCluskie and others — is inspirational. Even before Peak Health, these folks were showing up to meetings at the Division of Insurance, hearings at the Capitol, and town halls in Summit, making sure people heard their issues and debated possible solutions. They also did a lot of yelling at me as the insurance commissioner, and working with them seemed to be the only way to get them to stop.
What is the Community Purchasing Model?
Today, our health care system continues to grow imbalanced. On the industry side, consolidation and partnerships give more and more leverage to hospitals and insurance companies. Yet, the people paying for health care and health insurance — individuals, families, small businesses, entrepreneurs and our larger employers — grow more and more fractured, weakening their ability to demand better prices from hospitals, insurance companies and pharmaceutical companies.
Initially, the commercial insurance market is split in three — the individual market, the small group market (for small employers) and the large group market (for large employers). But then we fracture into smaller groups from there. The individual market has the Affordable Care Act — compliant plans, short-term plans, grand-fathered plans and others. The employer groups exist as their own silos, each one trying to work out its own deal. Everyone is chasing what they think will be lower premiums and better value, but those often turn out to be only short-term gains that exclude the sick, the vulnerable and people with pre-existing conditions.
I believe we have to find ways to empower consumers to act together, and to do so in a way that includes the sick, the vulnerable and people with pre-existing conditions. By bringing consumers together we can create leverage for consumers to negotiate more reasonable prices with hospitals and doctors rather than relying on insurance companies to negotiate for us. With those better prices in hand, we can then make insurance companies compete against each other for our collective business.
This is a proposal I call the Community Purchasing Model, and it is the idea I asked your Summit County leaders to help me launch over a year ago. It is exactly what it sounds like — the model puts the power in the hands of the community — the people and businesses buying health care and health insurance. It unites individuals, small businesses and large employers into a large purchasing alliance and gives the community a seat at the negotiation table.
That is where the Peak Health Alliance comes into the picture. You have two fantastic health policy advocates, Claire Brockbank and Bill Lindsay, working with the thought leaders from your community to make this concept into a reality. They are deep in negotiations with Centura, the other health care providers in the community, and with hospitals and hospital systems outside of Summit County, demanding better health care prices for all of you.
But I cannot stress for you all how important it is for the Summit County community to stay united as these negotiations and this model moves forward. The Community Purchasing Model can lead to sustainable relief for people purchasing health insurance in the individual market, for the school district, for Summit County employees, for the towns of Summit County, for small business owners and for large employers. However, that will only happen if you stay united. We are stronger when we act together.
Summit County and Beyond
I am lucky enough to say that the people I have worked with in Summit County over the last year have become friends. But Summit is only the first step. Once we prove that this model can be successful, I plan to take it statewide. Hospital costs and insurance premiums are increasing in every county in Colorado and as your insurance commissioner it is incumbent upon me to tackle the problem.
I salute all of the work that the folks in the Peak Health Alliance have done in the last year, as well as the relentless advocacy for the community undertaken by Summit County leaders over the years. I am honored to be working with them. The Community Purchasing Model is a viable solution that doesn’t just dance around the edges of health insurance premiums, but actually attacks the root causes of those premiums in a way that benefits everyone. Its success in Summit County will lead to a way forward that helps all Coloradans.
Michael Conway is the Colorado Insurance Commissioner.
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