Grand Junction, Colo. could be a model for healthcare reform

In an effort to regain control of a message that seems at times to have slipped away from him, President Obama is hosting a town hall forum on healthcare Saturday here on Colorado’s Western slope.

Obama has made a series of campaign-style speeches to communities around the country, making his case for reform. Yesterday he was in Belgrade Montana. But when he takes the stage in Grand Junction, Colo., he could be preaching to the choir.

Politically it’s far from a stronghold for Obama, who lost Mesa County by nearly 30 points in 2008. But when it comes to healthcare reform, Grand Junction has some of the highest quality, lowest cost care in the country.

The national average for Medicare reimbursement is $8,300. But in Grand Junction it’s about $2,400 less.

Healthcare costs differ from state to state, and even within states, according to The Dartmouth Atlas of Healthcare. For example, the average Medicare reimbursement in Boulder, Colorado is over $9100. In Los Angeles, it’s nearly $11,000 and in Miami, it’s $16,000.

Healthcare experts say reform legislation is more likely to pass now than when the Clintons tried during the 1990s largely because Obama has centered the debate on cost, not access to care. And while they may not agree on various aspects of the legislation, it also appears more of the key players are on board. That’s where Grand Junction comes in.

John Hopkins, CEO of Rocky Mountain Health Plans, says communication is what makes care so affordable here. Doctors meet regularly with the HMO to talk about a variety of topics, including quality of care, pharmaceuticals, healthcare infrastructure and overall costs.

As a result, the HMO was ahead of the curve when it started using generic prescription drugs to keep costs down. The area also uses an electronic network to share patient information and is mindful of unnecessary tests and extended hospital visits.

“More care doesn’t necessarily result in better care,” says Hopkins.

The foundation for low cost, high quality care was set in the 1970s when doctors and members of the community came together to decide on a system in which physicians are paid a similar amount regardless of whether their patients have Medicare, Medicaid, or private insurance.

“Over the years we’ve always taken a look at what is the particular use of a procedure or a particular technology, and is it being used appropriately,” says Hopkins. “And that’s getting input from the practitioner, from the physician, and using that as an education opportunity.”

Kenneth Thorp is a healthcare policy expert at the Rollins School of Public Health at Emory University in Atlanta. Thorpe has worked with Democrats on reform legislation, and he says the model in Grand Junction can be replicated. Vermont is working on a plan where all patients in a community health plan would have the same access to care, regardless of who’s paying the bill.

“One of the proposals in play would be to have Medicare contribute dollars to the states and then have the states create these Rocky Mountain Health Plan-type operations statewide and nationally so that more patients could avail themselves of a proven better approach of managing and treating patients,” says Thorp.

Despite the earful some members of Congress have received at town hall forums in their home districts, Professor Thorp believes healthcare reform will pass once Congress returns from the summer recess.

“I think that once members come back and hear the success stories like [Grand Junction] and understand that people with insurance are looking for models that will improve their healthcare, will improve their access to primary care services, will reduce the cost of healthcare -- that there’s going to be more interest in the fall to really build on those types of models and hopefully be a little bit more aggressive with the legislation,” says Thorp.
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