Kevin Lewis, CEO of Maine Community Health Options (MCHO), a consumer operated and oriented plan (CO-OP) serving residents of both Maine and New Hampshire, details how his organization has found success while many other CO-OPs have failed in an interview with healthcare reform expert Kip Piper in his latest MediStrategy podcast.
CO-OPs initially were formed during the beta round for the Affordable Care Act. When the public payer option wouldn't pass through Congress, the Senate Finance Committee came up with the alternative plan to create CO-OPs, which increase choice and give consumers more clout, Lewis explains.
Piper points out MCHO's ability to surpass its 15,500 enrollment goal in its first year of operation by signing up more than 40,000 members, and also notes it's the most successful of the 26 nonprofit CO-OPs around the country.
First and foremost, as Lewis explains, MCHO was formed out of the desire to do things differently in terms of how to achieve the triple aim. Ultimately, MCHO wanted to bend the cost curve while also improving population health.
Lewis elaborates on MCHO's mission: The idea of a partnership between members and providers with the goal of providing members with the care they need. "We often disassociate ourselves from the role of improving our own health, and that's come at a great cost," he adds.
Lewis attributes MCHO's success to its internal operations. MCHO members sit on the board--being member-led is a key distinction from other plans, and it matters to a lot of consumers, he adds. Additionally, MCHO has a broad network: It's a PPO that focuses on timely treatment for its members.
So while other CO-OPs have been unable to reap early success--the Louisiana Department of Insurance announced the state's CO-OP will discontinue selling coverage at the end of 2015, for instance--MCHO is a shining star, as Piper puts it.
This is Part 1 of a two-part series. Check back tomorrow for remaining insights from the podcast.
- here's the podcast link