While the fate of the Affordable Care Act is unclear—there are certain areas regarding the future of health care on which many agree.
Payment reform, virtual care, transparency, bundled payments, narrow networks, and facility expansion were just a few of the trends discussed at The Future of Health Care, a recent event hosted by the Bellevue Downtown Association.
Representatives from four leading health care organizations in Washington state—Kaiser Permanente (as Group Health), Overlake Medical Center, Seattle Children’s, and Virginia Mason—came together to present their views on what we can expect to see in the years ahead. What follows is a list of the speakers and the seven most common themes.
• Dawn Loeliger, Executive Vice President of Strategic Planning & Deployment, Kaiser Permanente
• Tom DeBord, Chief Operating Officer, Overlake Medical Center
• Cindy Gazecki, Senior Vice President, Hospital Operations, Seattle Children’s
• Julie Sylvester, Vice President, Business Development, Virginia Mason
1. Payment reform
Loeliger, DeBord, and Sylvester all see a big movement from a fee-for-service model to one based on medical outcomes. There will come a day when physicians are no longer paid for every service they perform, and instead will be compensated for the quality of care provided. In fact, physicians who practice at Kaiser Permanente medical offices are already compensated this way.
This concerns price—and information—transparency. Providers and carriers are all working to be more upfront in their pricing, so patients can compare costs before choosing a provider, as well as know how much a service will cost before they get the bill. Regarding information, Kaiser Permanente members are able to easily access their medical records online, even via their mobile device. Virginia Mason is also developing mobile access.
3. Narrow networks
These smaller networks are able to offer quality care at better-managed costs. “Virginia Mason is part of the Puget Sound High Value Network, along with Seattle Children’s and Overlake,” noted Sylvester. “This narrow network was one of two selected by the Washington State Health Care Authority to provide health plan options to state employees.” Including its own physicians and medical offices, Kaiser Permanente’s HMO has been operating as a narrow network for years.
4. Ease of access
The idea here is to bring health care to where the patients are. Kaiser Permanente offers CareClinics, walk-in clinics at 10 area Bartell Drugs. Virginia Mason and Seattle Children’s both have Vera Health wellness centers on site for their employees. Kaiser Permanente, Seattle Children’s, and Virginia Mason all have a number of regional clinics. Children’s even flies its providers to certain health centers when needed.
5. Virtual care
Access of care can’t get much easier than from one’s own electronic device. Kaiser Permanente offers online visits, which allow members to receive diagnoses and prescriptions if needed for common medical issues—typically in an hour. Virginia Mason launched their Virtual Care Clinic that allows patients to receive care for about 100 medical issues over the phone or online, while Seattle Children’s is investigating telemedicine. All of which will cost less than a visit to the doctor’s office or urgent care.
6. Bundled services
Sylvester outlined a concept of centers of excellence where certain well-defined procedures with predictable outcomes would be bundled together and cost the same across the board. Kaiser Permanente is investigating a bundled approach for childbirth and knee and hip surgeries. In another effort to control costs, Kaiser Permanente promotes a shared decision-making model that allows patients to collaborate with the doctors on treatment choices. Typically, this leads to more conservative—and less costly—treatments.
7. Facility expansion
Population growth on the Eastside is driving Overlake’s expansion. Said DeBord, “Data suggests that the population aged 65 and older on the Eastside will increase by 29 percent in the next five years. And people in that age range use health care services at a rate that’s four times higher than those younger.” So Overlake is preparing for that influx of patients with project futureCARE. This $242 million facility expansion will bring a new five-story bed tower, cancer center, childbirth center, surgical suites, and more to the campus.
“We serve pediatrics and adolescents in four states: Washington, Alaska, Montana, and Idaho,” said Gazecki. “That makes up over 25 percent of the land mass in the U.S.” That helps explain Seattle Children’s growth plans, which include new buildings for their Laurelhurst campus and research institute, and a clinic on the Providence campus in Everett. Kaiser Permanente will be upgrading and expanding facilities in the years ahead.
All trends pointing toward lower costs
With health care costs seemingly always on the rise, lower costs can’t be considered a trend. But it is what health care professionals are striving for. Sylvester believes that when health systems come together in narrow networks, health care can improve and become more affordable.
Loeliger outlined the five elements that Kaiser Permanente considers critical to the quality and cost of health care: Providing the right care, at the right place, at the right time, with the right provider at the right price.
“The right price is the one we all need to work on,” she says. “If we can continue to drive forward on looking at right care, place, time, and provider, we’ll start to move toward the most affordable models of health care.”