Printed in the Durango Herald April 20, 2019

Local Solutions to Health Care Could Provide Relief

Rising healthcare costs have become a hot topic of discussion, particularly as insurance premiums and other medical expenses continue to soar. In fact, health care seems to come up as a discussion point more than the weather these days. Well, almost as much as the weather. Ask anyone living in La Plata County about health care, and you will probably hear the same story: rising costs, less coverage, and no relief.

I recently heard a statement that health insurance is more like “bankruptcy insurance.” And there is some truth to that. An annual report from the Colorado Division of Insurance backs our frustrations and decrease in spending money. In the 10-year stretch between 2008 and 2017, health insurance premiums rose 50 percent for people who had coverage just for themselves through an employer. For families with employer-sponsored insurance, premiums rose more than 60 percent — to an average of nearly $20,000 per year. That’s like buying a Subaru Outback every year just to be able to have health insurance.

And spending enough money to buy a new car only gets you entrance to the show, so to speak. Insurance premiums are covering fewer and fewer out-of-pocket expenses, with rising deductibles and increasing co-pays. According to analyses by the state’s Division of Insurance and the Colorado Commission on Affordable Health Care, spending for outpatient services in the Western Slope insurance region is about 87 percent higher than the state average. So, what are remote communities like Durango supposed to do to get a handle on these billowing costs?

Local First has teamed up with The Durango Network and San Juan Basin Public Health to conduct a community needs assessment for La Plata County, with a focus on small business owners with less than 50 employees. This study is identifying the barriers to entry for employers around health care and is looking for innovative solutions at the local level. The study focuses on independent, locally owned businesses because they find it more difficult to offer employer funded health care plans than their corporate and larger counterparts. This makes it more challenging to compete for employees as well as retain these employees.  

Focus groups in January revealed growing frustration among business owners that the solution to employee health care is on the backs of small business, and most everyone seems to be looking for a collaborative or cooperative healthcare solution. Health literacy was also identified as a top priority. The healthcare field is highly complex, and in order to tackle this confusing landscape, we need to understand it better. Notably, all 25 of our focus group attendees identified the healthcare topic as including not only insurance, but also health and well-being practices, such as alternative health care, workplace healthy habits, and exercise.

Leaders in Summit County may be on the brink of a solution that could be modeled here in La Plata County. The Peak Health Alliance just finished negotiations with Centura that may position the Alliance to be on the path to launch a cooperative healthcare program in 2020. Key components to their work included acquiring claims data to better understand the true cost of health coverage and inviting the entire community to get on board. The more partners in the health alliance, the more power to negotiate and work cooperatively. Support from the state’s insurance commissioner was a boon to this forming entity: Commissioner Michael Conway recently referenced existing enabling legislation that allows healthcare cooperatives to form in Colorado, which could greatly support the Alliance’s efforts.

The best thing that could happen in the area of health care these days is for progressive healthcare bills to pass the legislature, and for our neighbors in Summit County to wildly succeed so we can learn from their bold endeavors. To learn more about their efforts, we have invited these leaders to a summit on May 20 hosted by Local First and our partners at the Strater Hotel, from noon to 5 p.m. Save the date, and register at In addition to hearing from our neighbors, Local First will release the findings of our community needs assessment, and there will be a facilitated dialogue to explore a healthcare cooperative here in Durango. So don’t miss it!

Monique DiGiorgio is managing director of Local First in Durango. Contact her at