By Katie Kerwin McCrimmon
Nearly three out of four people who bought private health insurance through Colorado’s exchange selected nonprofit carriers: Kaiser Permanente, Rocky Mountain Health Plans and the Colorado HealthOP.
Nearly half picked Kaiser.
Kaiser enrolled 58,344 of 127,233 people — or about 46 percent — of those who bought insurance through Connect for Health Colorado between Oct. 1 and the end of open enrollment on March 31.
Rocky Mountain Health Plans enrolled 16,050 people or about 13 percent of the market and the Colorado HealthOP signed up 15,166 people or about 12 percent of all enrollees. Anthem Blue Cross and Blue Shield traditionally has been a big player in Colorado’s insurance market and has not released sign-up data yet.
A CIGNA spokesman said the company is not releasing state-by-state breakdowns. A Humana spokesman declined to share enrollment data. UnitedHealthcare and some smaller carriers did not respond to requests for their data.
Among all the exchange sign-ups, about 26 percent in Colorado came from people ages 18 to 34, slightly lower than the national number of 28 percent. Colorado HealthOP, a new health cooperative, appealed to a relatively high percentage of young people with nearly 34 percent of enrollees in the 18 to 34 demographic. For the HealthOP, sign-ups from younger people spiked in March when about 44 percent of all people enrolling were 18 to 34 years old.
HealthOP CEO Julia Hutchins said the overall sign-ups beat projections. The HealthOP drew a lot of attention for having barely-clad models strolling the 16th Street Mall in October, telling people to “get covered.” In March, street teams handed out juice shots and reminded people that it was “last call” for health insurance.
“We had more fun,” Hutchins said of the inventive marketing strategies. “We had a lot of young energy there and it might have been helpful in creating messages that really resonated (with) young people. But, we really are targeting people of all ages.”
Hutchins attributes the HealthOP’s enrollment success to giving customers a nonprofit, member-run option and said it may have been an advantage to be entirely new.
“It gives us a certain level of trust,” she said. “Our mission is to improve the health of individuals and communities as a cooperative health plan. We’re about working together to reduce the cost of quality health care for our members.”
For Kaiser, the sign-ups also exceeded expectations.
“We are really pleased at where we landed,” said Dr. Jandel Allen-Davis, vice president of government and external relations for Kaiser Permanente Colorado.
Since Kaiser has been on the Colorado scene since 1969, Allen-Davis said patients trust its deep roots. Cost and quality of care are also critical.
“The idea of being able to purchase high quality and affordable coverage … is an attractive option for people,” Allen-Davis said.
Kaiser has been adding clinics, providers and specialty centers to handle the growth and now serves more than 565,000 patients through 28 medical offices and a network of hospitals along the Front Range from Pueblo and Colorado Springs in southern Colorado to Fort Collins and Greeley in northern Colorado.
Kaiser does not offer health coverage statewide and many residents in Colorado’s resort areas were furious this year when they discovered they get charged the highest health insurance costs in the nation.
Allen-Davis said Kaiser has not yet decided whether to expand beyond its current territory, but is keeping a close eye on the Interstate 70 corridor and ski resort communities.
“We’re watching it keenly and we’ll see where it goes,” she said.
Rocky Mountain Health Plans sells coverage statewide and is the biggest carrier in western Colorado.
Neil Waldron, Rocky Mountain’s chief marketing officer and vice president of strategic initiatives, said he thinks affordability ended up being a dominant reason customers selected plans.
“If you want market share, you have to lead by price. But I don’t think everybody buys by price,” Waldron said.
For instance, Rocky Mountain linked with a high-quality group called New West Physicians in the Denver area. While those plans weren’t the cheapest in the Denver market, Waldron said they did well. He believes people want to see the doctor of their choice and bought those plans for that reason.
While Waldron said the overall numbers are solid, he would have preferred a better age distribution. He declined to give specifics, but said that Rocky’s age spread is similar to the statewide breakdown.
“Younger people are underrepresented in the numbers. We would have preferred more of those people, but the population is skewing older. That’s national, not just in Colorado.”
Overall, Waldron said he was surprised at how well the exchange launch went in Colorado.
“Given the complexity of what we were dealing with, it went very well. That doesn’t mean there weren’t problems. That doesn’t mean there aren’t still problems,” he said.
“But, especially for Connect for Health, it was an enormous task.”
Waldron said that in the fall he would have predicted the exchange debut would have been “a disaster.”
“But it wasn’t a disaster. They (exchange managers) worked very well with the carriers,” he said. “I think Connect for Health did a very good job.”
Like other health insurance executives, Waldron is concerned about making sure those who signed up pay and that they don’t drop out. Exchange officials predicted recently that up to 20 percent of people who signed up could fail to pay or drop out.
Lapses are a concern, Waldron said. He and others also are watching for people who get the health care they need, then simply stop paying premiums and essentially drop their coverage.
“You have the danger that someone will get their care and have a substantial medical procedure, then disenroll. We would definitely take a hit financially,” he said.
Hutchins of Colorado HealthOP said she would like to see the Medicaid sign-up system greatly simplified in Colorado. State Medicaid managers and exchange officials are supposed to be doing that — modeling a new system on Kentucky’s sign-up system. But they were also supposed to build an integrated system last year and didn’t succeed.
For Kaiser, one of the major challenges was not getting paperwork before new patients arrived seeking care.
Allen-Davis said Kaiser adopted a policy that if patients said they had signed up for Kaiser, the company considered them members. It often took much longer for paperwork to arrive.
Another challenge is helping people who have never had health insurance understand how the system works. To try to address basic questions, Kaiser has opened customer service centers in nine of its medical offices and has staffed them with bilingual agents.
Current and prospective members can stop in and ask questions about their bills, coverage and health care in general, said Amy Whited, Kaiser’s manager of public relations and digital media.
Along with adding patients through the health exchange, Kaiser is also now taking care of about 32,000 patients who get their insurance through Medicaid.
Allen-Davis said she and others at Kaiser have been working hard to promote the notion of getting covered.
“We went out to churches, community groups and a couple of legislative town halls on request to get the word out,” she said. “We’re excited to be part of the journey that the whole country is on.”