Talks between Peak Health Alliance, UCHealth break down
Peak CEO wants to 'leave the door open' for talks to continue
While the president of UCHealth Yampa Valley Medical Center says she believes discussions between the hospital and Peak Health Alliance have “come to an end,” the health insurance co-op’s CEO says she doesn’t “want to close the door totally.”
In an interview with the Steamboat Pilot & Today on Tuesday, Aug. 9, UCHealth Yampa Valley Medical Center President Soniya Fidler said the hospital stands behind a “really strong proposal” that was shared with Peak in March and would deliver “double-digit discounts.”
However, Fidler said that in the months since that offer, Peak has asked UCHealth to change “negotiating principals,” which she said isn’t possible. Fidler said she got an email from officials with Peak last week asking if the two sides were at an “impasse.”
“We’ve already communicated where we did have room to work and where we didn’t have room to work, so to be asked again, it was like it just does seem like we are at an impasse,” Fidler said. “For them to acknowledge that we are at an impasse was kind of good leverage, I guess, to say, ‘Yeah, you’re right.’”
On Wednesday, Aug. 10, Peak Health Alliance CEO Anne Ladd told the Pilot & Today the offer was for service at the Steamboat hospital, not the UCHealth system at large, which she said was problematic.
Ladd added that the offer also focused on a percentage discount, but what that discount would be off of was left unclear.
“They went straight to a price point, and there are things beyond the price point that are important to us,” Ladd said. “They’re saying we gave them a very good offer at a percent off, and we’re saying we can’t tell whether that is a good offer or not.”
“I think maybe the best way to say this right now is, yeah, we’re kind of at a pause point,” Ladd continued.
Both Fidler and Ladd declined to share specifics about UCHealth’s offer.
Peak Health Alliance is a health care-purchasing cooperative that was created in Summit County in 2018 and has since expanded to seven Colorado counties.
The effort to bring Peak into Routt County started last September with hopes to offer plans by January 2023. However, last month Ladd said the focus had shifted to 2024.
Peak is not an insurer. Instead the co-op acts as a sort of middleman that works with providers to negotiate lower fee schedules and then tries to find a carrier to offer cheaper plans based on those fee schedules.
After receiving the hospital’s proposal in March, then-Peak CEO Claire Brockbank said they were “disappointed,” and added that it lacked the specificity Peak wanted. Brockbank left the role in March to take a job in New York, and Ladd replaced her as CEO.
Ladd said the proposal lacked information that Peak needed to do an analysis and that it was a “status quo way of contracting,” — differing from how Peak has dealt with other health care systems in recent years.
But Fidler said the structure of the proposal was “very standard” for UCHealth and that she believed it would have allowed Peak to offer cheaper plans after dealing with other aspects of the health care system.
“We were very optimistic that a carrier would be excited to receive that type of proposal and bring a product to market in Routt County and ultimately result in lower premiums for out community,” Fidler said. “I believe that we’ve come to an end in the discussions with lots and lots of effort to make this work.”
For talks to continue, Ladd said she believes that any proposal from the hospital would need to include the whole system, and not just services in Steamboat. She also said Peak needs more specificity in the proposal to be able to evaluate it.
“I’m not willing to close the door totally,” Ladd said. “We’ve taken a step backwards … but I firmly believe that patience and time will move this.”
Fidler was not optimistic about talks restarting.
She said some of the changes Peak is asking for could create problems with current payers and that they have tried to work with the co-op to further explain the proposal, but “they didn’t take us up on that offer.”
As she has done throughout the process of Peak trying to enter Routt County, Fidler pointed to a variety of initiatives the hospital has taken to reduce the cost of care in Routt County such as opening an urgent care center for situations where an emergency room would be an unnecessarily high level of care.
Even without Peak offering plans, the Colorado Option law passed last year could still lead to lower costs.
Preliminary rates from the Colorado Division of Insurance show plans offered by Anthem and Rocky Mountain Health Plans in Routt County may be cheaper than Peak-sponsored Bright Health plans in Summit County, though these rates reflect what carriers requested their premiums to be and could eventually be lower when finalized.
Peak has said Bright Health, which has been criticized for being slow to pay providers in Summit County, was not going to be the carrier for plans offered in Routt.
Despite talks breaking down, Ladd said Peak would continue meeting with three carriers about offering plans for 2024. If one is identified, she said it could be a way back to the negotiating table.
“Even if it is just a crack, we’ve got to leave the door open,” Ladd said.
To reach Dylan Anderson, call 970-871-4247 or email danderson@SteamboatPilot.com.
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