Montana CO-OP, 1 of just 4 left, returns from hiatus with high hopes

The Montana Health CO-OP stopped selling plans voluntarily in December because it was worried it was headed toward insolvency. (Getty/Srongkrod)

The Montana Health CO-OP—which just resumed selling health plans after a nine-month break—now bets that it has what it takes to be one of the few Consumer Operated and Oriented Plans left standing.

The nonprofit health plan, which serves both Montana and Idaho, stopped selling plans voluntarily in December because it was worried it was headed toward insolvency, the Associated Press reports. The CO-OP lost about $6 million in its first year and more than $40 million the year after that.

“When all the other CO-OPs were going down, we were losing money, too,” said Jerry Dworak, Montana Health CO-OP’s CEO. “Thankfully, we’ve turned things around.”

Whitepaper

Key Realities Pushing Healthcare Into a Digital Future

Paper forms, contracts, and documents are the quicksand that bogs down both patient care and provider business. However, that does not have to be the case. Download this whitepaper to learn the three key realities that are pushing healthcare past paper-based processes and into a digital, more streamlined future.

The insurer now projects $28 million in profits, and State Auditor Matt Rosendale told the AP that he feels the CO-OP is “very strong.” Yet Rosendale also noted that he doubts the insurer will be able to repay the $85 million in loans it got from the federal government under the Affordable Care Act.

In addition, threats to the CO-OP’s future still lurk on the horizon. Though congressional Republicans’ push to repeal the ACA has waned, Montana Health CO-OP President Larry Turney said he worries that enrollment would plummet if there was a major disruption in the marketplaces, such as the end of consumer subsidies.

RELATED: Senate GOP's 'skinny repeal' fails after John McCain defects

Including the Montana Health CO-OP, only four CO-OPs remain out of the original 23. One of the latest to close its doors is New-England-based Minuteman Health, which said in June that it would shed its CO-OP identity and create a new company. The CO-OP was later placed in receivership by Massachusetts regulators.

Maryland-based Evergreen Health tried to make its own transition to a for-profit company, but that plan failed when potential investors backed out of the deal, as FierceHealthcare reported. Not long after, CEO Peter Beilenson, M.D., resigned.

Not only have CO-OP closures through the years lessened competition on the ACA exchanges, but they’ve also negatively affected the remaining on-exchange insurers. That’s because CO-OP members tend to be higher utilizers of healthcare services, and when other plans absorb them, they then become responsible for the high costs associated with them.

Suggested Articles

Signify Health, a technology company that supports in-home care announced plans to merge with Remedy Partners, a software company that collaborates with…

A spat between CVS Caremark and a birth control subscription service led to a social media firestorm, with calls to #BoycottCVS trending on Twitter. 

There are big changes coming to the pharmacy industry and the traditional industry players will need to innovate and pivot to health and wellness to stay ahead.