Summit County, Colorado, is located seventy miles west of Denver and is home to six historic mountain towns nestled in the Rocky Mountains. The county is known for its high elevation, historic mining and first-rate skiing. While living in this county has many benefits, it also has another distinguishing feature – some of the most expensive health insurance premiums in the country.
Statewide, Colorado has seen steady increases in health insurance premiums. What makes Summit County unique is its high cost of care in spite of being consistently labeled as one of the healthiest counties in the nation. According to US News and World Report, Summit County has a life expectancy age of 97, and exceptionally high rankings for mental health and health conditions. Yet 12% of the population is without insurance, higher than the national median, and the county ranks poorly when it comes to access to care. These are some of the many factors that prompted the formation of the Peak Health Alliance in 2019.
Independent and locally-led, Peak is a purchasing alliance made up of small and large group employers and those who buy health insurance on the individual market. The alliance was formed with the goal to better negotiate health care plans with payers and providers. Utilizing the purchasing power of the community, Peak has worked relentlessly to offer new comprehensive plans at competitive rates. However, before being able to offer new rates and plans, and to engage providers and community members, Peak first had to gain a better understanding of what was happening in their health care market.
Working with CIVHC and the CO APCD, Peak was able to access health claims data specific to Summit County. Initially, the employer alliance was eager to understand what services were being provided in their county and at what cost for commercial plans compared to Medicare rates. They also needed to understand what services Summit County residents were travelling outside of their county for and where they were receiving them. After receiving their data and custom report, Peak was able to determine that employers paying premiums and residents purchasing individual coverage could save millions of dollars if inpatient and outpatient payments were reimbursed at more reasonable rates.
Peak then looked to partner with health insurance carriers that would support their goals, and ultimately chose Bright Health to serve the insured market. While self-funded employers can work with any qualified third-party administrator (TPA) in partnership with Peak.
In its 2 years of operation, the alliance has already lowered premiums by 39-47% for employers and members. Outside of lowering premiums, they continue to work to expand access to critical services such as dental and vision, behavioral health, physical therapy and more, while also encouraging members to receive care from local providers. Since Peak’s inception, the alliance has expanded, with 7,000 members throughout Dolores, Grand, Lake, La Plata, Montezuma, San Juan and Summit counties.