While more than half of consumer owned and operated plans around the country are closing, one CO-OP has found a way to survive despite a slow start, according to an article in Connecticut NPR.
Ken Lalime, who runs the state's CO-OP, Healthy CT, started the organization with doctors from the Connecticut State Medical Society, the article says. As the third enrollment season for the Affordable Care Act begins, the state's CO-OP is still going strong.
In the first year of its existence, Healthy CT only received about 3 percent of all the state's healthcare insurance business. Lalime didn't know who his customers would be, he didn't know what their health conditions would be and he didn't know how much to charge, according to the article. But the slow amp-up was actually a good thing. Paperwork was not overwhelming, the amount of claims to pay were relatively low, and those he did have to pay were not very expensive, Lalime says.
This success story's beginning is quite different from another New England CO-OP's start. Maine Community Health Options attributes its CO-OP success to its unique program benefits being coupled with a large provider network as well as its ability to quickly adapt to any challenges. CEO Kevin Lewis also credits the contributions of its board members, having a broad network and providing timely treatment as the keys to Maine's CO-OP success.
In the second year of its existence, Healthy CT grew from providing 3 percent of the state with coverage to 18 percent, as the company had more back-office experience, more time for consumer outreach and a more competitive price, according to Lalime.
"There's some more healthy competition here, that's great," Lalime told NPR. "We think that's a fine thing that the ACA wanted to do this, and the benefit goes to who? The benefit goes to the consumer."
The CO-OP program's struggles have been the target of much political scrutiny, with officials unable to pin down a single cause for so many of them closing. But some CO-OPs and small insurers have formed a coalition to push for changes to regulations they say are causing their financial struggles.
To learn more:
- read the article