The healthcare industry in Colorado is facing potential challenges as Intermountain Health, a prominent health system, plans to expand its insurance plan into the state next year. This move has raised concerns among independent community hospitals, such as Community Hospital based in Grand Junction. Chris Thomas, the CEO of Community Hospital, recently voiced his apprehensions about Intermountain Health’s intentions during a Senate Finance Committee hearing on consolidation within the healthcare industry. The potential impact of Intermountain’s expansion and the fear of restricted access to care have become significant points of discussion within the healthcare landscape.
Intermountain Health, headquartered in Salt Lake City, recently merged with Broomfield-based SCL Health, integrating eight SCL hospitals into their network. As part of this merger, St. Mary’s Medical Center, one of the two hospitals in Grand Junction, became a part of Intermountain Health. This consolidation of healthcare resources has already brought changes to the region, and the introduction of Intermountain’s insurance products further raises concerns about potential limitations on patient access.
Intermountain Health’s Expansion Plans:
Intermountain Health is planning to expand its insurance plan, SelectHealth, into Colorado in 2024. SelectHealth, already serving over 1 million members across Utah, Idaho, and Nevada, views this expansion as a significant opportunity for growth. Pending regulatory approvals, SelectHealth intends to offer Medicare Advantage and individual plans on the Colorado exchange. Curt Howell, SelectHealth’s Colorado market president, highlights the advantages of their insurance model, emphasizing scalability and the ability to reach a large population quickly.
The Concerns of Community Hospital:
Chris Thomas, the CEO of Community Hospital, expressed his worries about the potential consequences of Intermountain’s insurance expansion. He fears that Intermountain Health’s hospitals, including St. Mary’s, will become tier one facilities, leading to an influx of patients while leaving independent hospitals like Community Hospital at a disadvantage. If Intermountain Health succeeds in attracting a substantial number of insured lives, the CEO foresees a decline in the number of commercially insured patients at Community Hospital. To address this concern, Community Hospital is collaborating with other independent healthcare providers in the state to establish an integrated network that can partner with a large commercial payer.
The Impact on Healthcare Access:
The entry of a dominant health system like Intermountain Health into the insurance market can potentially influence patient choices and healthcare access. Tiered insurance products often prioritize network hospitals, possibly redirecting patients away from independent hospitals and towards Intermountain’s facilities. This shift could disrupt the existing patient-provider relationships and impact the viability of community hospitals that have been serving the local population. While Intermountain Health’s expansion may bring certain benefits, it is essential to consider the potential consequences and ensure that access to quality care remains readily available to all individuals in the community.
Building an Integrated Network:
Recognizing the challenges posed by Intermountain Health’s expansion, Community Hospital is proactively seeking solutions. By collaborating with other independent hospitals in Colorado, Community Hospital aims to create an integrated network that can effectively partner with a large commercial payer. This strategic approach allows independent hospitals to maintain their relevance and provide competitive alternatives to patients, while also preserving the quality and continuity of care within the community.
The concerns raised by Chris Thomas, CEO of Community Hospital, shed light on the potential implications of Intermountain Health’s insurance plan expansion into Colorado. The fear of restricted access to care and a shift in patient volume towards Intermountain’s facilities highlights the challenges faced by independent hospitals. As the healthcare landscape evolves, it is crucial for stakeholders to engage in collaborative efforts, such as building integrated networks, to ensure that patients continue to have access to high-quality care options within their communities. By addressing these concerns proactively, the healthcare industry in Colorado can navigate the changing dynamics and uphold its commitment to serving the needs of the population effectively.