EDITOR’S NOTEBOOK: Northern Colorado will jump — or be pushed — to HMOs

Northern Colorado has been slower than the rest of the Front Range to embrace managed-care options for health care, but that soon could change.

Essentially, managed care lowers health-care costs while also limiting options. A health-maintenance organization, for example, will contract with health-care providers for their services, paying them upfront to treat members.
In return, the HMO restricts members from using physicians and other providers not in the system. Thus, HMO members might not be able to see the physician they want, and it’s often more difficult to see a specialist — at least when a physician might do.
In Larimer and Weld counties, employers have opted in significant numbers for less restrictive plans that give employees the option of seeing health providers in the system or those that aren’t.
Also, health-care costs have traditionally been lower in Northern Colorado, reducing the pressure to embrace a more restrictive system. As HSI Health Plans Inc. president Chuck Mabry says, local physicians have always done a good job of holding down costs.
What’s changing is the emergence of HMOs nationally and statewide, with Northern Colorado a prime target for new enrollment. Also, new HMOs are entering the Northern Colorado market, heightening competitive pressures. HealthLink, a new HMO soon to be offered by HSI, will target members throughout northern and northeastern Colorado. Colorado Access will serve Medicaid patients in clinics such as Sunrise Community Health Center in Greeley.
And PruCare will expand its HMO offering to this area in early 1996.
Concurrently, many HMOs are offering alternative plans to provide some of the choice options traditionally found in preferred-provider organizations. That change will inevitably lead to increased enrollment in the area’s HMOs, as will the fact that employers benefit from reduced health-insurance costs and reduced costs for their employees.
Many also believe that HMOs provide superior care because they promote prevention rather than just treatment of illnesses.
What does all this mean for Northern Colorado? It means that businesses that previously have steered away from HMOs are likely to embrace them in the future.
If not, the future will embrace them.