Kaiser Permanente Colorado members will be able to use CommonSpirit hospitals in the Denver area for health care after the two announced an agreement this week.
Starting early next year, four CommonSpirit hospitals will be in-network for inpatient care, meaning Kaiser Permanente customers won’t have to pay as much if they want to use them. The facilities include: St. Anthony Hospital in Lakewood, St. Anthony North Hospital in Westminster, OrthoColorado Hospital in Lakewood and Longmont United Hospital.
Kaiser members could already use those hospitals for emergency care. Under federal and state law, insurers can only require their customers to pay the in-network rate for emergency care, even if they go to an out-of-network facility. Patients who go to an out-of-network hospital for scheduled care can find themselves liable for the difference between what their insurance pays and what the hospital charges.
Patients will have the option to seek care at those four hospitals some time in the first quarter next year, though exactly when will depend on how quickly they can sort out scheduling and credentials for doctors employed by Kaiser Permanente, said Mike Ramseier, president of Kaiser Foundation Health Plan of Colorado.
The plan has about 515,000 members statewide, with the majority living in the Denver area.
Kaiser Permanente is an insurance company, but also employs doctors and operates clinics where its customers get most of their routine care. In some states, it also owns hospitals, but in Colorado it contracts with other health systems.
An unspecified number of Kaiser’s providers will work in the two St. Anthony locations and OrthoColorado, starting in 2025. Depending on their specialties, some doctors will work full-time in the hospitals, while others will do most of their work at Kaiser’s clinics and go to the system’s hospital partners for specific procedures, Ramseier said.
Providers employed by the hospitals will take care of Kaiser Permanente customers who have an emergency, but Kaiser doctors will handle planned admissions, such as surgeries, said Andrew Gaasch, president of CommonSpirit’s mountain region. The two sides could make changes to that arrangement if it isn’t working well in some cases, he said.
“This is what we would call a side-by-side model,” he said.
CommonSpirit had a difficult start to the year, losing money in the first quarter and temporarily going out-of-network with Anthem BlueCross BlueShield of Colorado. The two sides reached a deal after more than two weeks.
Kaiser Permanente and CommonSpirit already had a partnership in southern Colorado. Kaiser customers there could get inpatient care at Penrose Hospital, St. Francis Hospital and St. Francis Hospital Interquest in Colorado Springs, as well as St. Mary-Corwin Hospital in Pueblo and St. Thomas More Hospital in Cañon City.
The agreement with the Denver-area CommonSpirit hospitals will give patients more choices, Ramseier said. He declined to say how long the agreement will last, but said it will be longer than five years.
“This is about being patient-centered,” he said.
CommonSpirit has reached out to its other existing partners to talk about growth opportunities, Gaasch said. The Denver-area hospitals already have plans to grow and accommodate more patients, including in a recently built tower on the St. Anthony North campus.
“We’re committed to increasing our impact in our communities and growing with our communities,” he said.
The announcement came as Kaiser Permanente also is growing. The system is building new facilities in Lakewood and Parker, and planning renovations for some of its other clinics in the state.
“Colorado is really competitive (as a health care market) and Colorado is growing,” Ramseier said.
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