Letters to the Editor : Article on PVH, insurers’ dispute one-sided

nThose of us who work at Poudre Valley Health System and know that we deliver high-quality, efficient care to our patients were very disappointed in reporter Helen Taylor˜s one-sided diatribe about costs at Poudre Valley Hospital.

We believe that Ms. Taylor allowed herself to be set up as a mouthpiece for the giant health-insurance companies whose positions she seemed to be vigorously trying to promote in her July article. After reading her article, one would be led to believe that Poudre Valley Hospital is responsible for all increases in group health insurance rates. Unfortunately, Ms. Taylor failed to include a number of facts that we provided when she spoke with us about this story. Here are some of those facts:

n Less than 6 percent of Poudre Valley Hospital˜s patients are insured by PacifiCare, so it˜s highly doubtful that PacifiCare, a California-based, for-profit, multi-million dollar national corporation which made a $38.8 million profit in Colorado alone, was forced to its financial knees by 6 percent of Poudre Valley Hospital˜s business.

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n PacifiCare˜s attempt to make PVH˜s per-procedure prices look expensive is highly puzzling. PVH now has a capitated contract with PacifiCare for most of its commercial business. What this means is that PVH and Fort Collins physicians have agreed to take on the financial risk by agreeing to accept reimbursement from PacifiCare in the form of a set dollar amount per patient per month to care for all PacifiCare subscribers. This makes the prices of procedures irrelevant. We provide whatever care the patients need for the set amount per month. Furthermore, data from the Center for Healthcare Industry Performance Studies show that our charges are below the lowest quartile among equivalent hospitals in Colorado. We know that we provide health care in a very efficient way.
n We are in total sympathy with local employers facing PacifiCare˜s plans to raise rates by a stunning 35 percent in Northern Colorado, as reported in the media. We are wondering if PacifiCare, needing to deflect attention from this whopping increase, is trying to get their customers to focus instead on PVH. Because we now have a capitated contract with PacifiCare, all extra money from these rate increases will go directly to PacifiCare and not to health care providers. Because of our capitated contracts, we˜ve already agreed to accept set dollar amounts per patient per month as full reimbursement from PacifiCare.
n PVH has not raised its rates to PacifiCare or any other provider in over four years. Can PacifiCare say the same? In fact, in 1997 PVH decreased its rates to PacifiCare, resulting in savings to PacifiCare of over $1 million. Did PacifiCare pass any of this rate reduction on to the residents of Fort Collins? This means that PacifiCare is actually paying much less for health care today than they were four years ago, yet they still feel compelled to engage in a campaign of misinformation so that they can return even higher corporate profits to their shareholders in California and other states.
n Newspapers all over the country are reporting that HMOs and managed care insurers everywhere are raising rates this year. It is part of a commonly recognized, six-year "underwriting cycle" whereby health insurers typically enjoy three profitable years, followed by three losing years. What typically happens is that insurers "buy" the business, enticing companies to enroll with their plan by offering prices that probably won˜t cover their costs. They get by with this for a year or two because of clauses in their policies that impose a waiting period before they provide coverage for "pre-existing conditions." But once they are faced with paying these bills, they begin to lose money. That˜s when they start raising rates.
n According to Colorado Managed Care, a managed care newsletter, PacifiCare was by far the most profitable HMO in Colorado in 1997. They made $38.8 million in the state in 1997 (the next closest company was Kaiser with $8.4million in profit), and PacifiCare˜s medical loss ratio was 86 percent, which means that for each insurance premium dollar PacifiCare received from you, it only spent 86 cents on health care for your employees and kept the rest for itself.
n Finally, Ms. Taylor mixes apples and oranges when she compares PVH income to that of PacifiCare. PacifiCare is the third insurance company in the past few years to own the manged care programs it has in Colorado. Because PacifiCare is a publicly traded stock company, all of its profits go to stockholders. Make no mistake, PacifiCare˜s primary goal is to make as much money as possible in Northern Colorado, and then send that money to shareholders in California and other states. Poudre Valley Hospital, on the other hand, is a nonprofit community hospital which has served Larimer County for the past 75 years. All extra income we bring in goes directly back into community health improvement or is used to enhance the facilities and medical technology needed to deliver outstanding health care to our customers.
Faced with the downside of the underwriting cycle, PacifiCare has chosen Poudre Valley Hospital as a convenient scapegoat. But a close examination of the facts negates their arguments. We have come to expect that PacifiCare would try to blame PVH, but we are disappointed that Ms. Taylor allowed herself to be such a willing pawn in their game.

Ed Egger,
vice president
community relations,
Poudre Valley Health Systems

Support Mulberry & Lemay project

I am writing to express support of the proposed Mulberry and Lemay Crossings project, including Wal-Mart as a tenant. As a resident in the north and the owner of two local small businesses (The Fort Collins Tennis Center in north Fort Collins, and Miramont Sports Center in south Fort Collins), I am well aware that north Fort Collins is underserved in many realms. While much of our growth is to the south, population density is very high in the north, and residents and employees currently must go south for much of their discount and convenience shopping.
I feel that the Mulberry/Highway 14 entrance to our community is, for the most part, an eyesore. The architecture and landscaping of the project is nothing like the "big box" shopping centers on the south, and will, in my opinion, enhance the gateway into our city. From everything I have heard, the project owner is going the extra mile to make sure this shopping center is consistent with the high standards of our community. And Wal-Mart is committed to creating one of the most unique and architecturally pleasing stores in the western United States.
I disagree with the argument that large discount stores will take the place of our locally owned specialty shops downtown. To me, these are two completely different atmospheres, and should be able to coexist and complement each other. Instead of traveling to the south end of town and spending the day there, north-enders will be able to do their convenience, discount and specialty shopping without ever going south of Mulberry.
I look forward to the day when my employees and customers, who live and work in north Fort Collins, have the resources and services right in their own neighborhoods. Moving the project to I-25 simply encourages urban sprawl, and causes folks to travel further for their needs. Let˜s face it. We˜re growing. People want to live and work here. Let the free enterprise system take its course. Please support the Mulberry and Lemay Crossings project.

Cliff Buchholz
Fort Collins PacifiCare˜s attempt to make PVH˜s per-procedure prices look expensive is highly puzzling. PVH now has a capitated contract with PacifiCare for most of its commercial business. What this means is that PVH and Fort Collins physicians have agreed to take on the financial risk by agreeing to accept reimbursement from PacifiCare in the form of a set dollar amount per patient per month to care for all PacifiCare subscribers. This makes the prices of procedures irrelevant. We provide whatever care the patients need for the set amount per month. Furthermore, data from the Center for Healthcare Industry Performance Studies show that our charges are below the lowest quartile among equivalent hospitals in Colorado. We know that we provide health care in a very efficient way.
n We are in total sympathy with local employers facing PacifiCare˜s plans to raise rates by a stunning 35 percent in Northern Colorado, as reported in the media. We are wondering if PacifiCare, needing to deflect attention from this whopping increase, is trying to get their customers to focus instead on PVH. Because we now have a capitated contract with PacifiCare, all extra money from these rate increases will go directly to PacifiCare and not to health care providers. Because of our capitated contracts, we˜ve already agreed to accept set dollar amounts per patient per month as full reimbursement from PacifiCare.
n PVH has not raised its rates to PacifiCare or any other provider in over four years. Can PacifiCare say the same? In fact, in 1997 PVH decreased its rates to PacifiCare, resulting in savings to PacifiCare of over $1 million. Did PacifiCare pass any of this rate reduction on to the residents of Fort Collins? This means that PacifiCare is actually paying much less for health care today than they were four years ago, yet they still feel compelled to engage in a campaign of misinformation so that they can return even higher corporate profits to their shareholders in California and other states.
n Newspapers all over the country are reporting that HMOs and managed care insurers everywhere are raising rates this year. It is part of a commonly recognized, six-year "underwriting cycle" whereby health insurers typically enjoy three profitable years, followed by three losing years. What typically happens is that insurers "buy" the business, enticing companies to enroll with their plan by offering prices that probably won˜t cover their costs. They get by with this for a year or two because of clauses in their policies that impose a waiting period before they provide coverage for "pre-existing conditions." But once they are faced with paying these bills, they begin to lose money. That˜s when they start raising rates.
n According to Colorado Managed Care, a managed care newsletter, PacifiCare was by far the most profitable HMO in Colorado in 1997. They made $38.8 million in the state in 1997 (the next closest company was Kaiser with $8.4million in profit), and PacifiCare˜s medical loss ratio was 86 percent, which means that for each insurance premium dollar PacifiCare received from you, it only spent 86 cents on health care for your employees and kept the rest for itself.
n Finally, Ms. Taylor mixes apples and oranges when she compares PVH income to that of PacifiCare. PacifiCare is the third insurance company in the past few years to own the manged care programs it has in Colorado. Because PacifiCare is a publicly traded stock company, all of its profits go to stockholders. Make no mistake, PacifiCare˜s primary goal is to make as much money as possible in Northern Colorado, and then send that money to shareholders in California and other states. Poudre Valley Hospital, on the other hand, is a nonprofit community hospital which has served Larimer County for the past 75 years. All extra income we bring in goes directly back into community health improvement or is used to enhance the facilities and medical technology needed to deliver outstanding health care to our customers.
Faced with the downside of the underwriting cycle, PacifiCare has chosen Poudre Valley Hospital as a convenient scapegoat. But a close examination of the facts negates their arguments. We have come to expect that PacifiCare would try to blame PVH, but we are disappointed that Ms. Taylor allowed herself to be such a willing pawn in their game.Ed Egger,
vice president
community relations,
Poudre Valley Health SystemsSupport Mulberry & Lemay projectI am writing to express support of the proposed Mulberry and Lemay Crossings project, including Wal-Mart as a tenant. As a resident in the north and the owner of two local small businesses (The Fort Collins Tennis Center in north Fort Collins, and Miramont Sports Center in south Fort Collins), I am well aware that north Fort Collins is underserved in many realms. While much of our growth is to the south, population density is very high in the north, and residents and employees currently must go south for much of their discount and convenience shopping.
I feel that the Mulberry/Highway 14 entrance to our community is, for the most part, an eyesore. The architecture and landscaping of the project is nothing like the "big box" shopping centers on the south, and will, in my opinion, enhance the gateway into our city. From everything I have heard, the project owner is going the extra mile to make sure this shopping center is consistent with the high standards of our community. And Wal-Mart is committed to creating one of the most unique and architecturally pleasing stores in the western United States.
I disagree with the argument that large discount stores will take the place of our locally owned specialty shops downtown. To me, these are two completely different atmospheres, and should be able to coexist and complement each other. Instead of traveling to the south end of town and spending the day there, north-enders will be able to do their convenience, discount and specialty shopping without ever going south of Mulberry.
I look forward to the day when my employees and customers, who live and work in north Fort Collins, have the resources and services right in their own neighborhoods. Moving the project to I-25 simply encourages urban sprawl, and causes folks to travel further for their needs. Let˜s face it. We˜re growing. People want to live and work here. Let the free enterprise system take its course. Please support the Mulberry and Lemay Crossings project.Cliff Buchholz
Fort Collins