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Valley Health Alliance works for big changes in local healthcare

Community

Valley Health Alliance works for big changes in local healthcare

by Aspen Valley Hospital

November 25, 2020

A unique collaboration known as the Valley Health Alliance has shaken up the health care landscape from Aspen to Parachute by playing an instrumental role in providing residents and business owners new choices for their health insurance coverage.

UnitedHealthcare will be offering group health insurance to businesses, nonprofits and other organizations, and Rocky Mountain Health Plans will be selling individual health insurance plans. They will both be competing with Anthem Blue Cross Blue Shield, which for a number of years has been the only insurer serving this region. Enrollment opened on November 1.

The addition of two new insurance companies in Pitkin, western Eagle and Garfield counties marks the first time in several years that people will have a choice among insurance carriers. The rates being offered by UnitedHealthcare and Rocky Mountain Health Plans are extremely competitive with Anthem, and less expensive in some instances.

“We’re thrilled that all the work we’ve done over the years is giving people a choice for their healthcare coverage that hopefully will translate to lower costs, now and in future years,”  says Chris McDowell, Executive Director of the Valley Health Alliance.

For businesses and other organizations wanting to learn more about UnitedHealthcare’s plans there are three insurance brokers selling it in our area, including Devlin Financial Services in Aspen, and Glenwood Springs Insurance and Mountain West Insurance in Glenwood Springs. Those buying on the individual marketplace, which include sole proprietors and businesses using the new Individual Coverage Health Reimbursement Arrangement (ICHRA), all health insurance brokers can help, including the three named above plus Martin Insurance, Michael Sailor Insurance and Roaring Fork Insurance in the mid and upper valley. The individual plans can also be compared and purchased through the state of Colorado’s Connect for Health Colorado website.

The Valley Health Alliance (VHA) formed several years ago when Aspen Valley Hospital and large, self-insured employers like the Aspen Skiing Co. and Pitkin County government started looking for ways to reduce costs. It has since grown to incorporate all three area hospitals, six large employers, doctors with practices up and down the valley, five local Chambers of Commerce and Mountain Family Health Centers.

The health insurance story is the organization’s latest and most visible outcome, but it has had a hand in what is a significant regional transformation of health care. Beginning in 2017, the VHA set about to find a way to lower costs while also supporting the extensive care that is available here.

“What’s remarkable about the Valley Health Alliance is how it is built on trust,” says Aspen Valley Hospital CEO Dave Ressler. “Many of us have been working on these issues for years, and we can understand each other’s needs and viewpoints, which allows us address the real challenges that come up when addressing such a complex issue.”

VHA has developed a sophisticated approach to managing that complexity and produce real outcomes for the community.  For instance, the VHA has partnered with the Community Care Alliance, a Grand Junction-based organization that provides data and information systems to improve the way healthcare providers — from the largest hospital to the smallest primary care office — deliver care.

In recent years, many employers and insurers have added incentives for people to develop a relationship with a primary care doctor. That relationship has proven key in lowering overall costs because people have someone they can talk to about their health and the decisions they need to make. Primary care is at the heart of a clinically integrated network that also includes specialists and hospitals. That network now includes more than 260 healthcare providers from Parachute to Aspen.

Dr. Kelly Locke, a longtime local family physician who works at Aspen Valley Primary Care has had a hand in developing the primary care model here as a member of VHA’s Clinical Advisory Board.  “We’re able to look at care in a granular way, through data analysis that lets us see patterns in usage and demand, and make recommendations based on people’s needs,” he says.

“If patients are driving to Denver for a particular treatment, do we want to bring that type of specialist to our area? Is there sufficient access to after hours clinics so people don’t go to the emergency room if they need to see a doctor at 8 p.m.? If we answer these and other questions correctly, we can provide better care at a lower cost,” Locke says.

Of course, that’s just the tip of the iceberg. Every party in the healthcare system has a different stake and outlook. Large, self-insured employers and small businesses that provide health insurance for employees have very different relationships with the healthcare system, as do insurance companies, hospitals, primary care practices and specialists. But ultimately, they are all now striving for the same result: The right care at the right time in the right place for the right price.

“It’s so important that providers and hospitals and employers and employees are all part of the same team at the Valley Health Alliance,” says Dr. Gary Knaus, who practices family medicine in Carbondale and leads the Clinical Advisory Board. “The idea is to keep the healthcare services that we need in our communities — and make it accessible and affordable for all who need it.”

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