Health care in Junction ‘innovative’

By Gary Harmon
Sunday, December 18, 2011

Lauded as a pioneering approach to providing health care to more people at a lesser cost, the Grand Junction health care model is much the same as that used by a venture capitalist.

“It’s a very entrepreneurial and innovative process that people are following” in Grand Junction, said Claudia Brink, assistant director of the Indiana University, Bloomington, Workshop in Political Theory and Policy Analysis.

Brink and workshop Director Michael D. McGinnis are working with Nobel laureate Elinor Ostrom in her study of the Grand Junction model and other well-regarded health care systems in Bloomington, Ind., and Cedar Rapids, Iowa.

The study is being conducted under a $295,000 grant from the Fannie E. Rippel Foundation.

Brink and another researcher conducted about 40 hour-long conversations over the summer with people in Grand Junction, many of them directly involved in health care, some indirectly.

“The process is pretty simple, it’s pretty well-known in business,” Brink said. “You identify a poorly met or unmet need, you find people who can help” and work to resolve the issue, Brink said.

The process is a bit more than that, though, Brink noted.

“In Grand Junction, you are not afraid to address problems with blood, sweat and tears,” she said. “Where others chase money, you donate blood.”

And with some frequency, she said.

“I probably can come up with about 60 examples” of similar instances, Brink said. One that leaped to mind was a nascent effort to help autistic adults, Brink said.

There are parallels, Rocky Mountain Health Plans President and CEO Steve ErkenBrack said, noting that “historically we see a problem, view it as an opportunity to improve things, and deploy the resources of the community in a coordinated fashion.”

The difference between the approach in Grand Junction and venture capitalism is the profit motive, ErkenBrack said.

“I think the challenge is that ‘entrepreneurial’ typically has the maximization of profit as the sole motive, whereas here there has been a focus on doing the greatest good for the greatest number through a private sector system,” ErkenBrack wrote in an email. “Because it is private sector, each component has to pay attention to its bottom line; because the control is nonprofit, we do so with the ultimate goal of improving health care, not maximizing profit.”

The Grand Junction model is characterized by the involvement of nonprofit organizations, such as Rocky Mountain Health Plans, St. Mary’s Hospital, Hospice & Palliative Care of Western Colorado, Quality Health Network and other organizations, including the Independent Physicians Association of Mesa County, which enforces professional standards and acts to reduce unnecessary costs.

There is no reason the Grand Junction model should be limited to Grand Junction, Brink said.

“What we identified in Grand Junction is something that contradicts what some of the articles say, that it can’t be replicated because of the geographic isolation of the Grand Valley,” Brink said. “But people in Grand Junction don’t see themselves as isolated. They all seem to be masters at reaching out to state and federal officials and national associations.”

That willingness to look for aid and advice outside western Colorado seems to begin with Club 20, which was founded to win more state money for roads and emerged over the years as a primary lobbying and promotional organization for Colorado’s Western Slope, Brink said.

In her conversation with researchers, Club 20 Executive Director Bonnie Petersen said she found it interesting, but not surprising, that they were looking at the organization as a model in gathering a broad spectrum of people to resolve issues.

“What is surprising is that there are not more organizations like that in the United States,” Petersen said.

Brink and McGinnis plan to return to Grand Junction next summer to further discuss their findings, but they also will look for other communities willing to see if they can apply the Grand Junction experience to their localities, Brink said.