When President Obama was making his pitch for health care reform in 2009, he flew to Grand Junction, Colo., to praise the local medical community for cutting health care costs. "You're getting better results while wasting less money," he said. The area particularly excelled at providing cost-effective care to Medicare patients — in 2006, Grand Junction's per-patient Medicare costs were 30 percent below the national average. It wouldn't be surprising if the Affordable Care Act that Obama eventually signed in 2010, with its emphasis on lowering Medicare expenses, led more communities to follow the example of this largely blue-collar city of around 50,000 on Colorado's western slope.
But Grand Junction's health care story is more complicated than Obama's praise indicated. While Grand Junction has managed to provide low-cost care for Medicare recipients, it's not dramatically less expensive than other Colorado towns for non-Medicare patients. And therein lies the caution for localities that want to create low-cost medical havens: Innovation that lowers health care costs for one type of patient can sometimes push costs up for another.
A history of collaboration has helped Grand Junction rein in its Medicare costs. The town sits hundreds of miles from major medical centers in Denver and Salt Lake City, and its isolation has forced members of the medical community to work together. Back in the 1970s, area physicians formed an HMO — now known as Rocky Mountain Health Plans and available across the state — as well as the Mesa County Physicians Independent Practice Association, a group of primary-care doctors and some specialists. Together, the two organizations developed what RMHP calls the "Mesa County model."