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Gov. Polis is looking to take innovative Summit County health insurance alliance model statewide

A Colorado health insurance co-op, modeled after the Peak Health Alliance, could give employers greater leverage when negotiating health care prices

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Fresh off winning federal approval for one major health insurance program and still at work building another, Colorado officials are already moving on to their next big health policy idea: A statewide alliance of employers, modeled after one in Summit County, that would give organizations better leverage to negotiate health care prices for their employee plans.

Colorado Insurance Commissioner Michael Conway last month met with leaders from the Colorado Association of School Executives to talk about the idea, and Gov. Jared Polis touted the plan at a news conference last week.

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“We’re also looking at a statewide model that essentially empowers the customers to have better negotiating leverage with the providers to negotiate better rates,” Polis said.

“We are working hard with Commissioner Conway and others to expand that statewide.”

The alliance would take its inspiration from the Peak Health Alliance in Summit County, which succeeded in getting its local hospital to lower its prices by 20%. But state officials have not yet approved the insurance rates that sprung from that deal, meaning it’s still unclear exactly how much money the alliance model will save people.

Gov. Jared Polis speaks at a news conference in the Colorado Capitol. (Jesse Paul, The Colorado Sun)

How it would work

The basic premise behind the alliance model is that employers could get a better deal on health care prices if they banded together and negotiated directly with doctors and hospitals — rather than taking the prices that insurance companies have negotiated for them.

After the group of employers have negotiated their health care prices, they would then put their business up for bid to insurers, who would compete to offer the employers coverage tied to those prices.

Polis has previously talked about creating an alliance for public employers in Colorado, as first reported in The Denver Post. But a statewide alliance could also include private companies, as well as individuals shopping for plans on their own.

MORE: How Summit County residents, fed up with high health care prices, banded together and negotiated a better deal

Thus far, no organization has stepped forward and said publicly that it wants to be part of an alliance. A spokeswoman for the Colorado Association of School Executives said Conway’s presentation was strictly informational to get school administrators up to speed on the idea.

State lawmakers earlier this year passed a bill updating the rules for such cooperatives. That bill was one of three passed last session that could reshape how Coloradans buy health insurance — also including a bill that created a reinsurance program and another putting together a public insurance option.

How much it would save

Rates for next year won’t be finalized until this fall, but Polis said he expects the Peak Health Alliance will save employers in large- and small-group plans an extra 20% in Summit County. The savings for individuals shopping by themselves may be less, though, based on a Colorado Sun review of preliminary rate filings.

Peak Health Alliance CEO Tamara Drangstveit said she couldn’t comment, citing the pending rate-review. Nor could a representative from Bright Health, the insurance company that will provide individual Peak members with coverage.

Michael Conway (Handout)

And Conway was also circumspect.

“I think it’s going to blow people away,” was all he’d say.

The Sun’s analysis found that Bright Health is proposing to offer individual Peak members insurance with premium costs somewhere between 5 and 10% less in Summit County than what it is offering to non-Peak members. In real dollars, that translates to a few hundred to around $1,000 in savings per year for individuals who buy insurance on their own and don’t get it through an employer.

What comes next

There’s still a long way to go to create a statewide health alliance. An organization would have to be formed and employers would have to agree to join it. The process of negotiating health prices with doctors and hospitals is arduous, as Peak leaders discovered.

Meanwhile, though, it appears several more communities want to follow Summit County in developing smaller-scale versions of the plan. Conway said officials in Eagle, La Plata, San Miguel and Mesa counties are all studying the idea.

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