Our Purpose:

The Mountain Healthcare Coalition is a healthcare purchasing alliance* designed to increase education, encourage proper utilization of healthcare services, and develop more cost-effective, sustainable health coverage options for individuals, insured employers, and self-funded employers in Eagle County.

* MHC was established in 2019 as a 501c3 healthcare purchasing alliance in accordance with Colorado Revised Statue 10-16-1001

Our Goals & Objectives:

Our goal is to develop a new non-profit Healthcare Coalition that will possibly include a health purchasing collaborative. The Coalition seeks to develop more cost-effective, sustainable health coverage options for individuals, insured employers, and self-insured employers in Eagle County. The  Mountain Healthcare Coalition will be coordinated and led by Vail Valley Partnership.

Our goals include:

• Develop a comprehensive Community Healthcare Program to create more stability in insurance premiums, now and in the future
• Provide broader accessibility to health insurance and coverage options within the community
• Work to provide a community-wide wellness mindset and culture
• Provide education about access to a broader range of choices to promote better healthcare decision making
• Provide ongoing support to community health programming including but not limited to MIRA bus, health fairs, and related community health education efforts

Our Position:

The high cost of health insurance has been an ongoing and increasingly impactful issue in Eagle County. The difference today is the demographic data clearly shows an increased need for more health insurance options for the current and future Eagle County workforce. Addressing the high cost of health insurance is essential to the continued success and growth of our business community across industry sectors. A “yes, and…” approach is needed to fundamentally address the issue of health insurance cost; providers, insurance companies, and the government all need to be part of the solution and niche programs need to build on each other to support community needs.

Structure:

The Mountain Healthcare Coalition (“Coalition”, or MHC) will be an Eagle County-based nonprofit health purchasing collaborative. It will not be an insurance carrier, but rather an organization to lead community health efforts. As such, it will develop, implement and maintain health benefit solutions specific to the needs of our mountain communities. Mountain Health Coalition will work with Vail Health and the provider community to create sustainable relief to the high cost of health care in Eagle County by changing the way that individuals and employers negotiate, purchase and manage health insurance and educate the community on health-related issues.

We have formed a “health care coverage cooperative” as defined and used in Part 10, Article 16 of Title 10 of the Colorado Revised Statutes, perhaps more commonly known as a “health care purchasing alliance.”  The name of our cooperative is Mountain Healthcare Coalition.

The alliance will serve Eagle County and is intended to negotiate pricing with health care providers and then seek bids from health care payors for coverage proposals using the negotiated rates and one or more pre-established plan designs, which could then be offered to small employers and other entities including self-insured organizations and the individual market. The concept is that the purchasing power of numerous employers could be amalgamated and leveraged to negotiate rates materially lower than those now prevailing in the County.

Sustainable Market Reform:

Both Price and Utilization drivers will be addressed to ensure long-term sustainable effectiveness.

Price: MHC will work with the provider community to negotiate an equitable pricing strategy tied to objective measures such as Medicare-based reference pricing.

Utilization: MHC will work with providers, employers, and individuals to address ensure the right care is provided at the right time and in the right place. Together we will develop strategies to:

• Identify, create, and incent desired provider behavior
• Use benefit design and payment to guide provider and member actions
• Support and incent individual’s health literacy to bolster compliance, self-care, and engagement

Background and Situation Analysis:

With 55,148 people, Eagle County is the 15th most populated county in the state of Colorado out of 64 counties.

Tackling big issues such as health care and health insurance costs require an intentional, coordinated effort. We are thrilled to help lead efforts to bring an innovative plan to the community and are committed to building a program to support both our residents and our businesses. This is not an easy fix; it is a process. We’re fortunate to have the right organizations at the table to address it.

Vail Valley Partnership will serve as the convener of numerous community partners including Vail Health, local governments & special districts, self-insured employers, and the greater business community to launch an innovative health care program in Eagle County. The Vail Valley is well positioned to take an innovative yet pragmatic approach to addressing this issue.

The cost of health care started to resonate in our business surveys in 2014-15 and have continued to increase as a pain point for the community.

Why Do We Need to Address Health Insurance Costs – and more importantly, Community Healthcare?

Are we able to implement a localized health care solution within Eagle County to support businesses and community by creating an environment that lowers health insurance costs for our residents in order to support our current and future workforce in a meaningful way and which also supports our local health care providers?

Eagle County’s population is currently one of Colorado’s youngest, but is rapidly aging. While the youth, 18 to 25, and 46 to 60-year-old segments of the population remain constant at 25%, 8%, and 19% of the total population, respectively, state demographers are predicting a decline in the “family age” group of 26 to 45-year-olds, from almost 40% of the total in 2005 to about 24% by the year 2035. The older population, 61 and above, grows markedly, forecasted to comprise 22% of the total by 2035.

Our aging population, and an increasing demand for lower cost insurance projects across industry sectors, requires a concerted community approach to insurance products. It is incumbent upon the community to continue to build a business-friendly environment, making Eagle County an attractive place to conduct business by creating an innovative health care group product that works for all stakeholders.