Negotiating Lower Health Care Prices Pays Off for Colorado Community

By: - September 11, 2019 12:00 am

A Colorado county’s efforts to bargain down health care prices will cut premiums for individual health plans in 2020 nearly in half compared to 2019. Hugh Carey/Summit Daily News via AP

A Colorado county’s efforts to bargain down health care prices is paying off.

Colorado Gov. Jared Polis, a Democrat, and the Colorado Division of Insurance announced this week that premiums for individual health plans offered by the nonprofit Peak Health Alliance in Summit County will drop by up to 47% compared to 2019 prices.  

“We ran the numbers for the silver plan and found that a typical family of four would save about ,000 dollars per year, a 35-year-old individual on a silver plan will save about ,600 per year,” Polis said in a press release.

Health care prices in Summit County, a mountain community known for its ski resorts, are significantly higher than in Denver — as are prices across Western Colorado. Local leaders formed the Peak Health Alliance last year to negotiate lower hospital, clinic and physician prices on behalf of some of the largest employers in the county, including the county government and the towns of Silverthorne and Breckenridge.

The nonprofit will team up with an insurance company to package those discounts into plans, which will comply with the Affordable Care Act.

The savings Polis announced are thanks in part to the reinsurance program that Colorado lawmakers passed into law and the federal government approved this year. The reinsurance program uses public funds to help health insurance companies pay their most expensive claims.

Polis said his administration now plans to replicate the Peak Health Alliance elsewhere. “It’s a model we are expanding statewide to save people money on healthcare.”

Insurance Commissioner Michael Conway, who helped develop the Peak Health Alliance, has been talking to large public employers — such as school districts — about creating a statewide version of the nonprofit.

However, a spokeswoman for Centura Health, parent company of Summit County hospital St. Anthony Summit Medical Center, told The Colorado Sun that she doubted the model could be replicated in other communities.

“In Summit County, the combination of dynamics on the expense side and the revenue side allowed for creative thought which created the Peak Health Alliance model,” Wendy Forbes wrote in an email to the Sun. “Unfortunately, these same combinations of dynamics do not exist in other communities throughout Colorado. Therefore, it is not possible to apply the same model used in one community to another community.”

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Sophie Quinton

Sophie Quinton writes about fiscal and economic policy for Stateline. Previously, she wrote for National Journal.