Plan-provider partnership looks to lower costs in northwest Colorado

As the Colorado Legislature nears the end of a busy session that saw several bills related to lowering residents’ health care costs, UCHealth and Anthem Blue Cross and Blue Shield announced an expansion of their partnership with the same goal.

UCHealth and Yampa Valley Medical Center (YVMC) in Steamboat Springs are lowering prices in order to offer Anthem’s Pathways HMO to employers and individuals in Routt County and northwest Colorado.

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At the end of last year, KUNC reported that people living in Colorado’s rural and mountain locations pay about $500 more per month for plans that are similar to those offered along the Front Range, and that the 26th Legislative District — which includes Routt County — sees among the highest health insurance costs in the state.

“For 80 years, Anthem Blue Cross and Blue Shield has provided access to quality, affordable health care in Colorado, and we take this commitment to the people and communities we serve very seriously,” said Jeff Sepich, president of Anthem, in a press release. “By collaborating closely with UCHealth, we can address the high cost of health care and work together to make the experience simpler for the consumer. The expanded reach of Anthem Pathways HMO will bring greater access to care and help make healthcare more affordable for individuals and businesses in northwest Colorado.”

The Anthem Pathways HMO is already available on the Front Range; now, the expansion should extend competitive premiums to individual and employer-based insurance plans in Routt County.

“This is another way UCHealth is working to lower overall health care costs,” said Soniya Fidler, interim president of YVMC, in a press release. “Over the last two years, we’ve lowered prices on MRIs, CTs, gastroenterology procedures and prices in our emergency department. We are committed to looking at ways we can continue lowering the cost of health care, be it through innovation, access to additional specialists or improving the overall health of our community.”

YVMC, which is about 3.5 hours from Denver and serves 51,000 patients per year, joined UCHealth in 2017. It’s the only hospital in Routt County, and the only Level III trauma center in northwest Colorado.

Photo courtesy of UCHealth.

“It just costs a little bit more to provide care up here,” said Lindsey Reznicek, Communications Specialist at YVMC. “But, thanks to this great partnership we’ve been able to offer out to the community and local employers, hopefully we’ll be able to do some things to address that.”

Steve West, senior director of employer services, payer relations, and network development with UCHealth, said the partnership came from conversations with large employers in Steamboat Springs, where he said “price is always coming up in the conversation.”

“We’re not the main facility in some of the other mountain counties,” West said. “In this one, we are. So, it was an opportunity where we could step in and say: ‘Hey, we want to solve this and partner with the local community.’”

West said the availability of Pathways should allow a covered patient in Routt County to access services where they live, rather than drive to Denver for care at a lower cost. And, it will keep specialists in the Front Range in their network.

“The big focus was: How do we help local employers so their employees can get closer to benchmark rates in the Front Range in their local facilities, so they don’t have to make that trip to Denver?” West said.

Pathways is now available to self-insured employers in the area and will become available for fully insured employers and individuals starting January 1, 2020, pending approval from the Colorado Division of Insurance.

“One of the biggest reasons why we partnered with this program, specifically, with Anthem, is because it’s not just for the employers — which is where the main focus was — but they also are the only carrier up there in the individual market,” West said. “So, those discounts extend to the individual market as well.”

West said UCHealth is also considering other ways to lower costs for Coloradans. He mentioned technology, and specifically telemedicine for appropriate follow-up appointments, as a potential strategy.

“We are looking at, geographically, what’ll be next,” West said. “I think UCHealth is always looking at how to reduce the total cost of health care.”