Mainebiz

V O L . X X I N O. X X I I I K evin Lewis and Robert Hillman took a huge leap of faith when they created their non- profi t health insurance cooperative Maine Community Health Options in 2011. As a startup whose business plan was based on an emerging health insurance model known as "Value- based Insurance Design," they were betting the com- pany's future on the principle that creating incentives for early and proper management of chronic illnesses such as asthma, diabetes, hypertension and chronic obstructive pulmonary disease was the right way to go, even if it meant signifi cantly reducing or even eliminating co-pay charges for preventive care visits and prescriptions proven to be eff ective in keeping people who have those illnesses healthy. In addition to competing against well-established health insurers in Maine such as Anthem Blue Cross and Blue Shield, Aetna and Harvard Pilgrim Health Care, they also faced the big unknown of whether President Obama's landmark 2010 Aff ordable Care Act would even sur- vive unrelenting political and legal challenges. Four years later, their consumer-operated and oriented health insurance company, or CO-OP, has far surpassed even their own expectations. After blowing past its 15,500 fi rst-year enrollment goal in 2014 by signing up more than 40,000 members in Maine— including 83% of those signing up for insurance using the federal health insurance exchange — the company expanded this year into New Hampshire (dropping "Maine" from its corpo- rate name for obvious reasons). It now covers more than 70,000 members in the two states. Of the 23 Co-Ops created by the ACA, it's the only one that was profi table in 2014, posting a net income of $5.9 million, according to a July report by the federal Department of Health and Human Services. For Lewis, the CEO of Community Health Options, and Hillman, its chief operating offi cer, these early successes affi rm the shared vision that a nonprofi t health insurance company — run by its P H O T O / T I M G R E E N WAY What continues to drive us are the powerful anecdotes we hear each and every day of the many ways we're improving the lives of our members. — Kevin Lewis, CEO Kevin Lewis (left) CEO Community Health Options, Lewiston Robert Hillman (right) COO Community Health Options, Lewiston Value- based insurance Kevin Lewis and Robert Hillman prove the value of a consumer-oriented approach to health insurance B y J a m e s M c C a r t h y O C T O B E R 5 , 2 0 1 5 20 Kevin Lewis, CEO of Community Health Options, left, and Robert Hillman, COO, in the nonprofi t health insurer's headquarters within Lewiston's historic Bates Mill complex.

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