A Local Approach to Better Healthcare

Background

When Summit County was among the most expensive healthcare premiums of any county in the US, community leaders took action.

In 2017, The Summit Foundation, a community-based non-profit, created a task force focused on tackling health insurance costs. Peak Health Alliance was formed in 2019 and began sponsoring plans in Summit County for the 2020 plan year. Over the next two years, Peak expanded its service area to include nearby Grand, Lake, and Park counties. In Southwest Colorado, Peak partners with the Local First Foundation to serve Dolores, La Plata, Montezuma, and San Juan counties.

Today, Peak is a locally managed 501(c)3 non-profit healthcare purchasing alliance that is licensed and regulated by (but operated independently from) the State of Colorado.

The mission of Peak Health Alliance is to leverage the negotiating power of an entire community to bring more affordable healthcare to individuals, families, and employers.

• Peak Health Alliance is owned by its members.
• Peak Health Alliance is funded by a member access fee that is included in premiums, and by grants from generous benefactors.
• For the 2022 plan year, Peak Health Alliance’s ACA-compliant plans are carried by Bright HealthCare in 8 Colorado counties including Dolores, Grand, Lake, La Plata, Montezuma, Park, San Juan, and Summit.
• Bright HealthCare is withdrawing from the Colorado market at end of 2022, which means that Peak Health Alliance will not be sponsoring plans for individuals and families during 2023. Peak Health Alliance is working to find a new health insurance partner, with a goal of bringing even better options to the market in 2024.
• Peak Health Alliance is not an insurance company, third party administrator (TPA), or medical provider. We are a community organizing group that works with local providers and civic leaders willing to help their neighbors access high-quality care at reasonable rates.

How Peak Works

By analyzing local claims data, Peak identifies what residents in a community are paying for care. That analysis is a starting point for negotiation with hospitals, other health care providers, and carriers. We then negotiate and design ACA-compliant plans based on each community’s needs.

By law, Peak Health Alliance is not allowed to bear risk, so we partner with insurance carriers to offer our plans in the regions we serve. For self-insured employer groups, Peak Health Alliance offers access to its negotiated rates directly to the employer’s chosen third-party administrator (TPA).

Building Success with Local Leadership

Each county served by Peak Health Alliance has different needs, different factors that yield varying costs, and different approaches to providing care. Peak Health Alliance relies on local steering committees that play a vital role in building local solutions, helping maintain strong community connections, and building strong provider relationships.

Real Insurance, Real Results

Although our focus is on local care, Peak members have access to ANY medically necessary care—even when it cannot be provided in their community. Our statewide network of hospitals includes the entire Centura statewide network, University Hospital, and Children’s Hospital of Colorado.

In its brief existence, Peak Health Alliance has saved members more than $16.1 million dollars across the communities it serves. These savings mean that money that would have been spent on premiums flowed back into the local economy.

Beyond simply reducing premiums, Peak focuses on expanding access to providers of critical services with innovative plan designs that include options like pre-deductible unlimited primary care visits, flat-rate imaging, free behavioral health therapy visits (not subject to a deductible), and dental and vision.

Options for Business

Peak has played a role in helping small businesses of nearly every size offer health insurance—often for the first time—through ICHRAs (individual coverage health reimbursement arrangements), an innovative, tax-free reimbursement program that helps control cost and maximize choice. Peak also offers health insurance solutions for businesses of any size, including price savings for self-funded employer plans.

Why it Works

Peak Health Alliance’s work starts with an emphasis on data and analytics. The information gleaned is shared with the community and our members become our advocates. We pool the purchasing power of entire communities and use that power to be a stronger negotiator with the big players that drive healthcare costs.

By partnering with employers, local hospitals, providers, and community leaders, Peak Health Alliance strives to build more robust, cost-effective plans for communities. Our goal is to ensure good coverage and access to local care without the barriers imposed by out-of-reach premiums, copays, and deductibles.

Click to learn more on our FAQ page.