Peak Health sees opportunity to lower premiums in Routt County, but time is running out for 2023

Peak Health Alliance CEO Claire Brockbank explains how the groups works to lower health care premiums during a meeting with community stakeholders on Oct. 7, 2021.
Dylan Anderson/Steamboat Pilot & Today.

The steering committee working with Peak Health Alliance believes there is an opportunity to lower the cost of health insurance in Routt County, but time to make it happen for the start of 2023 is running out.

In an update to the Routt County Board of Commissioners on Monday, March 21, members of the steering committee said they had talked to 72 local businesses interested in pursuing a Peak sponsored plan. Together, the businesses represent about 1,900 employees.

However, to offer plans on the small group, employer and individual market by the start of next year, Peak needs to negotiate a new fee schedule with UCHealth — an ongoing effort — and then get a new carrier to offer plans locally.

“Time is not our friend,” said Claire Brockbank, CEO of Peak. “There’s a real time crunch on the individual market because rates are filed only once a year … and that rate filing is coming down the pipe.”

Peak is a health care purchasing cooperative, not an insurer. Peak started in 2018 in Summit County and has had success lowering premiums elsewhere in Colorado. Peak started work last fall to enter Routt County’s insurance market, where there was just one other provider on the individual market at the time.

Brockbank said there are now two providers with Rocky Mountain Health Plans joining Anthem this year. However, the addition of a second carrier hasn’t lowered premiums, and the price on the lowest bronze plan from Anthem on the individual market still increased 12% in 2022, she said.

Peak hopes to secure more favorable fee schedules from providers and lower premiums. In Grand County, the premium for the lowest Peak-sponsored plan on the individual market is almost $100 cheaper than Anthem’s, Brockbank said.

Talks with UCHealth about a new fee schedule started last month, and Brockbank said they received the first proposal on Monday.

“Conversations have not always been easy, but they have been productive, and they continue,” Brockbank said. “We were very disappointed in (the proposal), but we did receive something so that’s glass half-full or glass half-empty — you get to decide.'”

Brockbank didn’t share many details of the health network’s proposal, though she said it was not as specific as she wanted it to be and that it didn’t include a list of procedures with prices.

In a statement to Steamboat Pilot & Today, UCHealth Yampa Valley Medical Center President Soniya Fidler said they have had constructive conversations with Peak over the past few weeks.

“Today, UCHealth shared a rate proposal with Peak Health Alliance that included double-digit discounts,” Fidler said “We hope this can be a continuation of the many ways YVMC and UCHealth have worked to lower the cost of care in Routt County.”

Fidler also pointed to the hospital’s efforts to decrease prices, offer discounts to health insurance companies and provide new, lower-cost versions of care, all of which she said has brought costs down locally.

Brockbank said in Peak’s review of hospital data — data that hasn’t been shared publicly — they saw a decrease in prices for inpatient care, but an increase for outpatient care. She also said that the percentage of what Medicare pays for services has increased in recent years, all of which makes her feel there is an opportunity to lower costs locally.

Peak also still needs to identify a carrier to provide the insurance, as Brockbank said they would not be working with Bright Health to offer plans in Routt County. Bright Health has been the carrier on many of Peak’s plans, including those in Summit County. The carrier then needs to be able to submit rates by the end of April to offer plans on the individual market by 2023.

Jason Lacy, managing partner at Steamboat Lawyer’s Group and a member of the steering committee, emphasized that the timing is tight.

“The goal is that we would have an insurance carrier for 2023 that would provide plans across all market segments,” Lacy said. “Because of the time crunch we’re under, it’s possible that we would have to start out with small-group and self-funded options first.”

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