A New Kind of Health Insurer for Maine People and Small Business

A New Kind of Health Insurer for Maine People and Small Business

I was pleased and honored to be invited to speak on behalf of MeHAF recently at the ribbon-cutting for Maine Community Health Options' (MCHO) permanent offices in the re-purposed Bates Mill Complex in Lewiston. MCHO is Maine's newest health insurer - a nonprofit "CO-OP"- ("Consumer-Operated and Oriented Plan") - authorized under the Affordable Care Act (ACA). The mission of MCHO is to increase consumer choice, competition and affordability in health insurance options for individuals, families and small businesses.

Although authorized under the ACA, MCHO did not spring into being without significant mid-wifery. The application for federal assistance and loans to launch MCHO was incubated at the Maine Primary Care Association (MPCA), with technical and financial support from MeHAF. As a health philanthropy dedicated to improving access to care and promoting care that is patient-centered, MeHAF Trustees felt that a nonprofit, consumer-directed insurer would be well-positioned to help more Maine people get quality health care in a timely fashion.

In 2012, MCHO was awarded $62 million in federal loans to design quality health plans to be offered on the federally-facilitate health insurance marketplace in Maine. MCHO's plans are currently being reviewed by Maine's Insurance Superintendent, and it fully expects to compete on the marketplace to offer Maine people and small businesses several plan options that will begin January 1, 2014. MeHAF is now providing assistance to support MCHO's marketing efforts to get the word out about their products, since the federal loans cannot be used for that purpose.

MCHO intends to work differently as an insurer. It will not only focus on helping its members improve their health, but will help to support Maine health care providers in delivering the right care at the right time and will encourage Maine communities to be healthier places to live. This is the essence of "value-based insurance design (VBID)," which experts believe holds promise for lowering overall health care costs. For more on VBID, see "Value-Based Insurance Design: Smart cost sharing can lead to better health at lower costs," August, 2012.

While MCHO's model is innovative, the organization still has a steep hill to climb. In order to reach its enrollment goal, it will need to help Maine people and small business owners, entrepreneurs, artisans, artists, farmers and fishers, understand that the ultimate value of its approach will be enhanced health for members and a more cost-effective health care system- not simply insurance coverage. The hope is that MCHO will help re-vitalize the health insurance marketplace with its new approach and nonprofit, consumer-directed leadership just as its new "digs" are helping to re-vitalize a historic Maine textile mill. From what I've seen of the team MCHO has brought together and the dedication and passion in evidence at last month's ribbon-cutting, if any group can succeed in the complex arena of health care reform, MCHO is that group!

 I'll be following news on the details of MCHO's insurance plans in the coming weeks as Maine's new  marketplace gets set to open - if you're curious about what this new kind of health insurer will offer, I hope you'll be tuned in, too!


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