The cost of healthcare is on the rise. In 2016, spending within the sector reached $3.3 trillion in the United States — about 18 percent of the country’s gross domestic product, according to a recent report from Moody’s Corporation, a business and financial services company. And those rates are expected to increase 5.5 percent annually over the next decade.
Although healthcare is the biggest employer in the country, employing about 16 million people — or 11 percent of the workforce — the negative impacts of increasing costs outweigh economic benefits accrued through employment or output.
It’s difficult to ascertain exactly what the economic impact — helpful or damaging — of healthcare looks like on the Eastside specifically. J. Michael Marsh, president and CEO of Bellevue-based Overlake Medical Center & Clinics, said that it is unclear how that data would be measured in a local environment.
“On the Eastside, we have an abundance of business and industry across multiple different services and occupations,” Marsh said. “So, even though (Overlake has) 3,000 employees, I suspect our economic impact is less than it might be if we were in a midsize town, where healthcare is usually the primary driver of the economy.”
Still, as one of the largest hospitals in the state, Overlake treats 150,000 patients each year, Marsh said, and is home to more than half a million total annual visits. To amplify that impact, the nonprofit hospital system focuses on ways it can keep healthcare costs reasonable without sacrificing high-quality care.
“In terms of impact we have on the community, (Overlake) serves as a very important safety net function,” Marsh said, referring to the $7 million in outright charity care Overlake provided patients in 2018, the $16 million spent covering Medicaid shortfall, and the $5.7 million dedicated to community benefit activities like health fairs and educational classes. “We have the most generous charity-care policy in the Puget Sound region. So, as a hospital that serves the needs of everyone, we give the same technology and passion and expertise to individuals who have no means as to people who have almost endless means.”
One of the specific ways Overlake is helping keep costs down is through a 2.5-year-old partnership with Kirkland’s EvergreenHealth.
“We have formed something with Evergreen called the Eastside Health Network because we are aligned in value-based purchasing — this notion of high-quality care at a more reasonable, predictable cost, Marsh said. “Together, we’re bending the cost curve while maintaining superior quality.”
Both Evergreen and Overlake consistently receive “A” grades from nonprofit The Leapfrog Group, which has been evaluating hospitals across the country on performance in cost, quality, safety, and efficiency since the early 2000s. The “A” grade, Marsh said, confirms that the measure of higher quality at lower cost is actually being met.
But because of the siloed nature of healthcare, these high standards can’t go far unless there is a more comprehensive approach on local levels.
“The goal is to knit things together,” said David LaMarche, chief administrative officer of the Eastside Health Network. “We’re a clinically integrated network that brings together employed and independent providers on the Eastside with three main objectives: to improve quality, cost, and patient experience.”
With a majority of primary care physicians and many specialty care physicians already under its umbrella, the Eastside Health Network stitches together communication and information among providers to offer lower-cost plans to employers like Microsoft and Boeing.
“We are one of a couple of different product options a Microsoft employee can pick,” LaMarche explained. “The goal is to provide a better experience for those employees and their families compared to other products that do not give them a lot of support to navigate what is a very confusing system.”
The benefits built by the Eastside Health Network, LaMarche emphasized, are not just for employees working for the Microsofts and Boeings. Currently, he said much of his time is spent working on creating options for companies with between 50 and 5,000 employees so that smaller businesses — and their workers — can understand their healthcare costs and dial in a nuanced plan that makes sense.
The Eastside Health Network helps combat the ballooning costs of healthcare on a local level by offering more comprehensive information to providers — alerting them, for example, of a new generic alternative or equivalent to a brand-name drug, which lowers cost and improves care — and by following up with patients — inquiring why someone went to the emergency room if urgent care would have sufficed, and deducing whether the problem stemmed from lack of information on the patients’ end or whether clinics need to be open later or earlier on given days.
“There’s no panacea yet,” LaMarche said, referring to different approaches and alliances created by healthcare organizations nationwide in order to push back against high costs. “We’re all testing models, and we’ll continue to make improvements and identify how we get people the right care at the right time at the best cost.”
Without engaging all of the providers on a continuum, there can be a breakdown of communication, which everyone has likely experienced to some degree in healthcare: the exhausting process of visiting a primary care doctor, then a specialized physician, then being sent home without sufficient resources or follow-up. It can be frustrating, how much gets lost between providers. And it can be expensive.
“If we can start to have that longitudinal conversation as a network, we think we can combat those rising costs and improve the outcome for patients,” LaMarche said.