“Flipping the Script” on Health Insurance

Oct 16, 2023

Local First’s Doug McCarthy: Peak Health Alliance is “Flipping the Script” on Health Insurance


Peak Health Alliance is fortunate to have a strong partner in Local First, an independent business alliance in Durango with some 260 member businesses.

On the Local First team is Doug McCarthy, who is highly knowledgeable regarding health insurance issues. His title at Local First is “healthcare advocate.” McCarthy has a way of talking about big concepts in simple terms. It’s almost plain old English!

It’s clear he is always thinking about the needs of individuals and families.

Doug knows the Affordable Care Act, Colorado health insurance laws, and understands the Colorado health insurance marketplace—particularly in the southwest corner of the state.

Recently, Doug McCarthy was a guest on KDGO radio station. He had a long conversation with Jack Lewellyn, the chief executive officer of the Durango Chamber of Commerce. You can listen to the full audio here.

The conversation lasted an hour. Lewellyn and McCarthy covered lots of ground. But here are a few interesting comments from McCarthy about Peak Health Alliance’s new partnership with Elevate Health Plans, backed by Denver Health Medical Plan.

Noted McCarthy:

  • Most health insurance companies looking at the Colorado market design their products based on the needs of Metro Denver, said McCarthy. That’s where Peak Health Alliance stepped in to “flip the script” on the conversation. “Let’s face it, that’s where the population is. And we’re kind of an afterthought down here [in southwest Colorado]. So we said, ‘We don’t want to be the afterthought. We want to be your forethought, right?’
  • Peak Health Alliance’s push for zero-dollar copays for mental health visits prompted the state to include that same concept in the Colorado option health insurance plans. “They said, ‘Hey, that seemed to work pretty good for Peak. Why don’t we build that into our health plan?’ So now that’s a standard for the whole state.”
  • Denver Health Medical Plans’ extensive history with individuals on Medicaid bodes well for their customer service. “Plans that serve the Medicaid market also tend to do the best [in the individual market] … because they understand how you work with people. So we’re excited that that’s their history.”
  • The Elevate Health Plans offer a “very simplified” plan design that will make it easy for individuals to comparison shop.
  • The ICHRA concept—Individual Coverage Health Reimbursement Arrangement—gives individuals the flexibility to choose the right insurance coverage for themselves and/or their families. “And the other neat thing about ICHRAs is that it will generally have lower premiums than you might pay for a traditional group insurance plan as the employer.”
  • One business in Durango saved $30,000 on their premiums and then used those savings to fund a Health Savings Account for their employees.

Rural communities deal with a shortage of providers, said McCarthy.

“We’re not worse off as some communities around the country that are really hurting. But we do have shortages in certain specialties, and it’s always a challenge to get primary care doctors,” said McCarthy. But “we’re pretty fortunate. We’ve had some folks in the community who have really stepped up and tried to help the community to understand what those problems were and the hospitals are filling those shortages. And I think we’re in a better place now than we have been in the past.”

Reminder: The open enrollment for the 2024 plan years begins on Nov. 1. To learn more, visit www.elevatehealthplans.org.