Dive Brief:
- Kaiser Permanente Colorado will move forward with its expansion into Summit and Eagle counties despite the two hospitals in the area (Vail Valley Medical Center and St. Anthony Summit Medical Center) not signing with the insurer for non-emergency visits. Kaiser will open medical office buildings on Jan. 4, 2016.
- The two counties rank among the top 30 most expensive counties in the U.S. for health insurance premiums - a problem local officials have been looking to solve. Kaiser's premiums are ranked among the lowest in the state, according to the Denver Business Journal. But, without the hospital contracts, Kaiser patients will only be covered for ED visits and will have to travel to Denver for other services.
- The company currently insurers close to 624,000 Colorado residents and estimates it will obtain "from hundreds to thousands of customers in the two counties," according to the Denver Business Journal. This will help to establish it as a statewide company.
Dive Insight:
Brent Bowman, Kaiser executive director for regional strategy, said, "We knew that, entering a single-hospital county in both cases, there would be a challenge. And that's why we entered with a long view. We knew we were not going to make money the first year...We have to commit to a 10-year proposition."
Bowman didn't cite any specific reasons for the contracts not being signed. However, Mark Carley, vice president of managed care and risk products for Centura Health, which operates St. Anthony Summit Medical Center, told Denver Business Journal he requested Kaiser to commit to two requests several months ago and never heard back from the company. One request was to keep patients local and the other was to use established community physicians and limit the number of new healthcare providers Kaiser brings into the area. "What [the lack of contract] is about today is the lack of correspondence between the two organizations," Carley said.
The situation, as aptly described by the Denver Business News, "exemplifies how local healthcare interests and the interests of businesses looking to expand statewide sometimes can be at odds with each other."