[copperpress-advertserve-ad-reload zone="3"]
ARCHIVED  June 18, 1999

HMO plans expansion to Weld, Larimer

A new health care insurance option for employers may soon be on the market in Weld and Larimer counties if a Longmont-based HMO’s plans are realized.

Proacta Health Partners Inc. is lining up providers in Loveland and Greeley to expand its operating territory northward by this fall, with an eye toward offering health plans in Fort Collins in coming years.

“We have a lot of people who work here and travel from up there,” Proacta CEO Rick Spears said from his Longmont office. “It makes sense for us to have providers in that market.”

The nonprofit Proacta, formerly known in Boulder County as Unicare, has been working with Greeley-based Western Plains Health Network for more than a year preparing to contract with doctors and other health care providers.

Western Plains is the management arm for 200 members of the High Plains Health Care Alliance, most affiliated with North Colorado Medical Center in Greeley, and the 100-member Mountain Shadows Medical Association Inc., a provider network centered at McKee Medical Center in Loveland.

“We’re very close to having this done,” said Tom Rohleder, business development director for High Plains. “Once we figure out the contract language, and the board approves it, then the physicians will have two weeks to notify us of their intent. ä We’re about 30 to 60 days out.”

Rohleder said he anticipates that most members of the two physicians’ associations will sign on as Proacta providers.

Once providers are enrolled, Proacta will file documents with the Colorado Insurance Division seeking authorization to expand its operating territory, a process that takes at least 30 days.

Spears said he hopes to have Proacta health care plans available to Greeley and Loveland area employers “by sometime in the fall.”

Proacta, described by Spears as a home-grown, local HMO, has 1,850 Boulder County residents enrolled in its plans, including almost all employees of the Longmont United Hospital and a significant number of Saint Vrain Valley School District workers.

“We need to get bigger, and a little less local, but still maintain our philosophy,” Spears said.”We started out and are based in Longmont. We do our own claims, customer service, marketing, all right here. We’d like to continue with that local orientation.”

Proacta’s small size might hinder its ability to compete in a challenging Northern Colorado market, a spokesman for a larger health plan said.

“Small numbers are difficult,´ said Neil Westergaard, spokesman for HMO Colorado, owned by Blue Cross Blue Shield of Colorado. “You’re not able to spread administrative costs to a broad enough base, and two or three catastrophic cases — premature births, or something requiring long-term care — can do a lot of damage.”

But Westergaard said that the competitive environment in the Greeley and Loveland markets and the small number of hospitals in the region make it difficult for one HMO to emerge as a dominant force.

“It’s typical of the whole state of Colorado,” he said. “We have lots of companies, but no clear leader.”

Proacta’s “globally capitated” plan presents some risk to providers who affiliate with it, Rohleder said. Under global capitation, once patient care costs rise to a threshold set by the HMO, doctors and other providers are not compensated for treatment.

But most providers find that the benefits of affiliating with capitated HMOs outweigh that risk, Rohleder said.

Once Proacta secures authorization to operate in Greeley and Loveland, Spears said he would turn his expansion efforts toward Fort Collins.

“We’ve talked to Fort Collins (providers), and we’d like to expand up there in the future,” Spears said. “It’s a phasing (in) process. It doesn’t make sense to do Fort Collins until we are in these other areas.”

Proacta’s entrance into the local market, where PacifiCare, BCBS, Antero (Mutual of Omaha), and Rocky Mountain HMO operate would benefit employers and consumers alike, Rohleder said.

“It gives them more choice, and keeps those guys competitive,” he said. “For the ultimate consumer, the employer groups, they get more competitive value. It will be a good impact.”

A new health care insurance option for employers may soon be on the market in Weld and Larimer counties if a Longmont-based HMO’s plans are realized.

Proacta Health Partners Inc. is lining up providers in Loveland and Greeley to expand its operating territory northward by this fall, with an eye toward offering health plans in Fort Collins in coming years.

“We have a lot of people who work here and travel from up there,” Proacta CEO Rick Spears said from his Longmont office. “It makes sense for us to have providers in that market.”

The nonprofit Proacta, formerly known in Boulder County as…

[copperpress-advertserve-ad-reload zone="3"]

Related Content

[copperpress-advertserve-ad-interstitial zone="30"]