A reader writes:
Susan, I just read your blog on the Corner and want to give you some perspective. I am a Director of a small rural HMO, not for profit, in the San Luis Valley of Colorado. We serve commercial insurance and Medicare members. Our 6 county service area is home to 47,000 people, 52% Hispanic, and includes 3 of the 4 poorest counties in Colorado. We have the highest rates of COPD [chronic obstructive pulmanary disease] and diabetes in the state. Centura Health Systems, (owned by CHI, Catholic Health Initiatives), despite their web site claims and mission values, will not even meet with us to contract with their hospitals. Centura says we are too small to contract with. We are the only insurance provider in the area. Our rates are consistently 10-15% below the out of area competition. So because they control much of the hospital access, they bill full charges and if our members go, we have to pay, while BC/BS who doesn’t even cover our area gets a blanket 30% cut in charges in every Centura facility. If we had the BC/BS rates, we could lower premiums even further and cover additional people. Currently, we cover most of the working adults in the valley but they cannot afford the premiums for their spouse and children. We could do so much more, but Centura/CHI is more concerned with the cost of doing business with a “small player”. This is probably the exception to their practice nationwide but is the antitheses of their stated values and mission. I certainly believe in a free market but deplore some getting a free ride in the press when, in my opinion, it is not deserved.
San Luis Valley HMO
He adds: I do appreciate many of the good things CHI has done and am obviously frustrated with their corporate decisions concering our health plan.