Summit County continues extensive planning and discussion on how to push down staggering health care premiums for the community. On Monday, the Summit Association of Realtors held a forum with a panel featuring three of the most important people with regards to insurance costs in Summit to discuss current efforts in Summit and across the state to bring down premiums.
The panel was made up of Colorado insurance commissioner Mike Conway, Summit Foundation Board of Trustees president Mark Spiers and St. Anthony Summit Medical Center CEO Lee Boyles. The three took turns outlining their goals and explaining how current and future initiatives will look to shrink health care costs in family budgets.
Conway, who had visited Summit for a similar health care forum last year, reiterated the point he made back then that the cost of health care itself is the main driver for huge insurance premiums.
“If we want to have long-term sustainable impacts to help people afford health insurance, we have to address the high cost of health care,” Conway said.
He added that even the proposed state reinsurance program, which would help insurance companies cover the cost for extremely expensive claims, would not be a long-term solution as it would not address the costs of providing health care. However, he saw it as a very important first step. That is, if it can pass the state legislature and avoid being killed by opponents.
“We know we’re going to have a fight on our hands, that the hospitals and some of the governor’s people don’t agree on how we’re going to pay for the bill,” Conway said, referring to the funding mechanism for reinsurance that has yet to be affirmed. “But that’s why we’re here, to have the back and forth about it.”
Conway said that he believed the groundbreaking community purchasing collaborative being formed in Summit County, known as the Peak Health Alliance, is the long-term solution Summit residents and other Western Slope counties have been looking for.
The Summit Foundation funded the initial actuarial study that led to the formation of the Peak Health Alliance. Spiers went over the findings from the study, including the fact that several common procedures, such as C-sections, were significantly more expensive in Summit than elsewhere. Spiers said that as a simple test, he tried to see how changing his zip code from Summit to Denver would affect the premium rates. He found that simply changing his zip to Denver reduced his projected premium cost by $350 a month.
The Summit Foundation along with other community leaders such as Tamara Drangstveit, Dan Gibbs, former St. Anthony CEO Paul Chodkowski and Summit Community Care Clinic CEO Helen Royal came together to find a way to rein in health care costs in Summit. They came up with the Peak Health Alliance, which would bring together the largest employers in the county as a single negotiating entity.
“It would be the representative for the people of Summit County, so we can have a seat at the table across from people like Lee [Boyles] and negotiate lower prices,” Spiers said.
Spiers said that he had been working well with Boyles since he took over at St. Anthony Summit, however the alliance has faced a bit of a brick wall with Centura’s corporate office in Denver. After more actuarial analysis, the alliance plans to present a full fee schedule to Centura and other providers, who will then return with a price schedule. If it all gets negotiated and finalized by April, Summit and the Western Slope should see premiums go down in cost by next January.
Boyles said that St. Anthony Summit is on board with the Peak Health Alliance, but wanted to remind people of several reasons why costs are particularly high here. For one thing, St. Anthony is a hospital with a charitable mission that provides charitable care and benefits to the community.
Additionally, like most other businesses in Summit, the hospital’s bottom line is driven by volume. When there’s great snow like this year, business is booming; but when we have a winter like last year’s, there are less patients to treat. Seasonal economies mean less stability, which can also have an effect on the cost.
Finally, Boyles said that 50 percent of the hospital’s operating costs go to wage and benefits for employees due to the high cost of living in the county. All of that, he said, needed to be taken into account when negotiating a fee schedule.
However, all three members of the panel agreed that the Peak Health Alliance was the way forward. And not only is it important to get the combined leverage of the current members on board, but getting other associations and individuals from the county involved in the alliance will certainly help drop costs.
“The more lives you have in there, the more risk you can spread around and that makes it much more affordable for folks,” Boyles said. “More lives means more buying power. The more you get, the better off you are.”