It is time to change the (healthcare) game
It is time to change the game
Our community is impacted by high health insurance costs. This comes as a surprise to no one. Vail Valley Partnership (VVP) has actively been working with local providers, insurance companies, elected & appointed officials, and others over the past sixteen months to develop a healthcare model that works to lower costs.
Front Range stakeholders simply don’t recognize the problem, despite continued hard work by our local elected officials to increase awareness, study options, and move the needle on insurance costs.
Our local hospital is not the problem (despite getting a lion’s share of the blame). Consider recent data shared by the area’s largest insurance provider at state healthcare meetings put neighboring community hospital pricing 17% – 31% higher than Vail Health. Vail Health has been working hard to make healthcare more affordable, with annual price increases averaging 2.35% for the past seven years versus nearly +11% annually for Colorado hospitals during the same period.
Vail Health also changed the Avon & Gypsum Urgent Care models to make pricing more affordable, offers 75 percent off urgent care pricing for uninsured residents, and expanded charity care to locals with an annual household income up to 350% of the Federal Poverty Guidelines.
VVP has spent the past year plus researching models as diverse as multiple-employer welfare arrangements (“small group” plans) to customized co-op plans. We’ve met with the state, with elected officials, with providers, with insurance companies, and with lobbyists, attorneys and consultants.
Our conclusion? The rules of the game simply don’t work for rural Colorado. Vail Health’s reasonable price increases are not reflected in lower insurance costs with ACA insurance rates rising between 20 and 32 percent each year from 2015 to 2017. Proposed legislation or system fixes are killed in Denver.
Rather than beat our head against an antiquated system, VVP is working with Vail Health and other partners to fundamentally change the game to better accommodate the needs of our community while maintaining the high-quality care and innovative approach they excel at. These things are not mutually exclusive and can be done at the same time.
How exactly are we changing the game? We have developed the One Valley Healthcare Program. The Program was developed in partnership with Small Association Leadership Alliance (SALA) and the result is a comprehensive and cost-effective alternative to traditional plans.
This new program offers affordable, accessible, and effective healthcare options for Partnership members. The Program helps businesses provide for the medical expenses of their employees through a community-centered approach, and allows community members to opt-in individually.
The One Valley Healthcare Program couples a choice of two preventative care plans with a medical cost sharing program covering unexpected or catastrophic events. Participants can expect to save up to 60% when compared to traditional group health insurance. A prescription drug and telemedicine program are also included.
The Program is not insurance. That means the State’s consumer protections or oversight of the operation of the plan do not apply. The amounts to be paid to the plan are not Insurance premiums and therefore are not regulated. The promise of future benefits is not guaranteed and thus the State of Colorado’s Guarantee Fund does not apply.
That said, we believe that this program helps address the high cost of healthcare in the mountain region in an innovative way. The program simplifies what has become so complex, by offering a high-end, affordable solution that provides preventative care with the choice of affordable options.
We changed the game to better serve the community. Learn more at OneValleyHealthcareProgram.com
Chris Romer is president & CEO of Vail Valley Partnership, the regional chamber of commerce. Learn more at VailValleyPartnership.com
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5 年Absolutely agree that the front range doesn’t get the issues we have in rural Colorado. After participating in a Statewide committee many of the committee members simply couldn’t understand why we didn’t want to drive to Denver for care. It was quite frustrating. Kudos to you for taking a grassroots approach.
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5 年One of the most telling things in this brief article is that the list of those working to solve the problem begins with "local providers". The ACA, like the 1990's effort at health care reform, excluded health care professionals and dismissed concerns about quality of care, denying that doctors, nurses, and other health care professionals had either any interest in cost containment or any insights to contribute. Genuine commitment to delivering quality care to all, a real and heartfelt force among health care providers, was of less concern than giving insurance companies power over purse strings and lawyers the ongoing access to wealth through frivolous litigation. When asked about tort reform, then president Obama commented that there would be no tort reform because "if we tie the hands of lawyers behind them, who will protect us from unscrupulous doctors?' With a view that sees no value in the input of health care professionals but looks at legal action as? playing a normal, desirable role in the health/wellness process, it is little wonder that costs rise, fewer people seek to become health care professionals, doctor/patient relationships die, and quality of care diminishes. ?
Katie and I were just talking today about how real change needs to occur on a local level instead of waiting for a top down approach. Kudos to you and the Vail Valley community.