Salt Lake City-based Intermountain Health says its biggest opportunity for growth is its insurance plan, SelectHealth, which will offer Medicare Advantage and individual plans on the Colorado exchange for 2024, pending regulatory approvals.
Becker's sat down with the plan's new Colorado market president, Curt Howell, to discuss its partnership with Aurora, Colo.-based UCHealth and how the move is poised to become SelectHealth's largest expansion yet.
SelectHealth currently has more than 1 million members across Utah, Idaho and Nevada.
Editor's note: Responses were lightly edited for length and clarity.
Question: Why do Intermountain and SelectHealth see so much opportunity for growth in Colorado?
Curt Howell: The great thing about SelectHealth is that it turned 40 years old this year, so it's not a startup and it has vast experience that it's bringing to the marketplace in Colorado. As I looked at this opportunity, I thought this was a perfect time to join this organization. I've competed against them most of my career and they were a formidable adversary. It's great to be a part of the team that brings all this experience to a marketplace around assets that we have on the ground.
The real magic of what we're doing is obvious when you look at Colorado itself — it's one of the fastest growing states in the union, with about 6 million people there by 2024. Between Utah, Idaho and Nevada, there's about 8 million people, so this is a really good opportunity for us to go after some membership.
We have assets through SCL Health. Through a clinically integrated network with UCHealth, we've also pulled together another 700 primary care physicians, hundreds of clinics and 18 hospitals across the state of Colorado. In a time when physicians are being squeezed from all sides, they now have an opportunity for providing healthcare and being rewarded for that time and attention to the member and their care — that's where the real magic and value-based care comes from with an alignment of incentives.
The timing is also really good, with the loss of carriers in the state over the last couple of years. We can come in and put a stop gap on those losses to create a high quality, affordable plan for Coloradans at a time when they've lost some options.
Q: From a bird's eye level, what are the steps you're taking to expand SelectHealth into a new market?
CH: It's pretty simple, but also incredibly complex. You really have to think about your product offering and what you bring to a marketplace.
We're an HMO, so we're not going to be all things to all people, and it all hinges on the product being approved. We're basically building out this product and figuring out what we want to take to the regulators. We have received feedback from them and we think we're on the right track to bring some exciting and unique nuances to a program that can be stodgy in some ways. We have some ideas around how to bring a unique offering to the marketplace for the more active outdoor senior, which fits pretty well with the Colorado demographic.
Then you've got to build a network around that, which requires thousands of contracts with every specialty you can imagine, and all in a way that is cost-effective. We have no lives at this point in Colorado, so we're leveraging our name and other assets we think will make providers want to work with us, maybe more than other carriers in the marketplace.
Q: Do you think every health system should be considering launching their own health plan?
CH: There certainly is a lot of vertical integration going on, and I think that is where we generally need to go. There are efficiencies that you gain when you've got control over the patient experience and member experience at the same time.
But should everybody do it? I don't know. There are systems who tried to go more vertical, and they don't exist in the Colorado market anymore. It's tough and everybody would be doing it if it were easy.
SelectHealth has a unique opportunity with a lot of experience that helps us in this space, and we can scale faster than brick-and-mortar can. It's probably not a great time to build a hospital, but we probably can bring on half a million to a million members in Colorado over the next five to 10 years.
Q: With Medicaid redeterminations currently underway, Colorado could see over 300,000 beneficiaries disenrolled from coverage. Are you hoping to capture some of those customers on the state's ACA exchange?
CH: Unfortunately they're all going to go shopping before we enter the market in January. But those members are only going to be with their carrier for a few months, and they may not have a great experience. My hope is that we can come in and give them an option that looks better and feels better than what they currently have at a price point that's attractive to them.
Q: We're seeing large payers drop commercial coverage offerings and really embrace government-sponsored health plans. What are your predictions for the next decade of health insurance in the U.S.?
CH: Colorado is a bit unique in the higher proliferation of individual coverage health reimbursement arrangements (ICHRA), where a small group or employer provides a defined contribution to employees and then you go shop on the ACA marketplace. Basically, here's the money, you decide how you want to spend it. I think there will be further proliferation of ICHRAs.
There's still a lot of baby boomers out there that aren't 65, so there's 10 more years of that generation to make it to Medicare Advantage and the further growth there. As we look at Medicaid, it grew massively through the public health emergency and is getting cut back a bit, so that ebb and flow will be interesting to watch. The exchange has continued to grow as well with more people either building their own business or doing other things that aren't traditional. However, I don't envision group coverage going away anytime soon.