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Here Comes Doc-In-A-Big-Box!

July 2007 Volume 2, Issue 7

Washington Healthcare News Articles, Interviews and Statistics for the Healthcare Executive

Inside this issue:

Here Comes Doc-In-A-Big-Box! 1

Healthcare Finance: The Investment Consultant Request for Proposal: Why it’s Needed Every Five Years

6

Healthcare Real Estate: Washington State Medical Office Building Listings

10

Healthcare Opinion: The Difference Between Success and Failure is 2% a Year

16

Career Opportunities 18

Plan and Hospital Financial Infor-mation

19

Interview with a Healthcare Leader: Jim Anderson of Adaptis, Inc.

12

Healthcare Administration: Managing a Successful Project

14

By Don Morgan, Director of Marketing, Palazzo Intercrea-tive

One of the most talked about hap-penings in the healthcare industry today is the emergence of in-store retail health clinics. These clinics offer convenient and affordable access to routine healthcare ser-vices and preventative care with-out the need to schedule appoint-ments. While the level of clinical care and the business models vary by retailer and location, all are based on the same value proposi-tion – a limited menu of health services in a convenient, walk-in retail environment.

The first MinuteClinic opened in a Cub Foods grocery store in Minneapolis in 2000, and since that time their numbers (and com-petitive entries) have swept across the country.

Target and Wal-Mart have been just two of the pioneering chains to test this new healthcare alterna-tive, and apparently they are satis-fied with the results as both have stated their intent to expand their

tests. Alicia Ledlie, senior direc-tor for Wal-Mart’s health business development, is forecasting that more than 6,600 in-store medical clinics will open their doors over the next five years.

Her predictions are based on the aggressive plans published by the major players and a host of new smaller players that are popping up all over the country. RediClin-ics have less than 100 units today, but have committed to 500 new locations by 2009. Take Care Health Systems, which currently operate in Osco, Rite Aid and Walgreens stores, plans to open 1,400 clinics by the end of 2008. Last year’s purchase of Minute-Clinic by CVS is just one more indication of the anticipated strength of these new healthcare outlets.

Smaller regional players, like Aurora Health Care, Pinnacle EasyCare, QuickClinic, Solantic, CuraQuick Clinic, The Little Clinic, MediMin, HEALTHspot, and MedPoint Express are just a few of the companies that can be found on a Google search. The

Convenient Care Association, an organization representing 18 com-panies that operate retail health clinics, held its first general meet-ing in March, 2007 at the Univer-sity of Pennsylvania, with over 200 industry personnel and ex-ecutives in attendance.

So, despite all of the consterna-tion, hand-wringing, and dire pre-dictions of the adverse effect on patient’s long term health or the patient-physician relationship by doctors and industry associations, this new retail phenomenon is definitely here to stay.

In-store retail clinics are succeed-ing because they offer consumers

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faster access to routine medical services. They are typically staffed by nurse practitioners, who can legally treat patients and-write prescriptions in many states without a physician. Some other states require a licensed physician to be available by telephone while examining the patient, but they don’t have to physically be at the location. And other states are re-viewing their requirements ac-cording to the American College of Nurse Practitioners.

In-store retail clinics are routinely used for common medical condi-tions like colds, ear infections, and strep-throat tests, and are moving rapidly into preventative care, including screening tests for high blood pressure and choles-terol, sports and camp physicals and flu shots, among other minor conditions and needs. They ap-peal to everyone from parents dropping by with sick kids on the weekend to busy professionals who don’t want to go through the hassle of scheduling an appoint-ment three days hence and then spend time reading two-year old magazines in a waiting room, or uncomfortably twiddling their thumbs in a cramped 6’x8’ office waiting for someone to actually talk to them.

This convenience is apparently

worth the typical $25 to $60 fee they charge. A 2006 Harris poll found that 90% of those who had visited an in-store clinic said they were satisfied with the quality of care, 83% were satisfied with the convenience provided by these clinics, and 80% said they were satisfied with the cost.

The emergence of retail clinics certainly raises several opera-tional and policy issues, but it also gives rise to a number of marketing implications. While these clinics offer a low-cost, low-overhead approach to healthcare, and a new source of revenue for their retail partners, it is important to realize that these clinics pro-vide a number of benefits that are not well met within today’s health care system.

Certainly the convenience of same-day service, or no appoint-ment necessary, is a desired bene-fit for today’s fast-paced, over-structured lifestyle. Most tout that you will be in and out in 15 minutes or less. The advantage of walk-in service is much preferred over the typical computer-assisted, impersonal telephone answering systems found in most physicians’ offices.

Even if the clinic is busy, patients in many stores are given a limited-range pager that allows them to shop for other items while waiting to be seen. The ability to multi-

task, and the convenience of im-mediate prescription fulfillment at the in-store pharmacy are other advantages that consumers say make these new clinics a desir-able option.

The AMA’s Council on Medical Services and the American Acad-emy of Family Practitioners have both issued recommended opera-tional guidelines and desired at-tributes for in-store retail clinics, as they recognize that these new clinics appear to fit with a larger trend toward consumer-driven health care. But just as they did years ago with the emergence of the much maligned “doc-in-a-box” emergency clinics, they are missing the point on why these new clinics are succeeding.

They are succeeding, and will continue to grow, because of the needs that are not being met in the current health care model. The AMA decries the loss of the pa-tient-physician relationship, while failing to recognize that many pa-tients complain that there is no relationship currently in exis-tence. With rising operating costs and skyrocketing medical mal-practice premiums, overextended primary-care physicians are al-ready assigning much of their pa-tient interaction to nurse practitio-ners and physician assistants. In-store clinics are, in many ways,

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Volume 2, Issue 7

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simply a more convenient way for patients to get much of the same care, so why shouldn’t the public support them?

The AMA and AAFP are cer-tainly correct when they caution patients against making too many of their own health care choices without consulting a licensed physician. However the driving factors of price transparency and choice are reasons that retail clin-ics offer a legitimate alternative resource to complement, if not replace the work of family doc-tors and other primary-care physi-cians. Physicians must acknowl-

lution Health. His web site, RevolutionHealth.com, is de-scribed as a consumer-health-themed social network, search engine, wellness advisor, personal health tracker, and on-line store.

Here comes doc-in-a big-box, and a whole lot more. Are you ready for it?

Don Morgan is Director of Mar-keting for Palazzo Intercreative, a full-service Seattle advertising agency that specializes in health-care. All material is protected by copyright, and cannot be repro-duced without the written permis-sion of the company. For more information, contact Don via e-mail at [email protected].

edge that without changes in their marketing, or in the conventional health care delivery system itself, these retail clinics will continue to grow in numbers and importance. And that will have a much more far-reaching impact on the wider health care system as insurance providers must now explore a dif-ferent claims system and worry about increased demands on health care as a whole.

As Forrester recently reported, “the winds of change are upon us”. They cite the recent acquisi-tion of Caremark by CVS as an-other important event to watch carefully. And they are also keeping a close watch on AOL co-founder Steve Case’s new Revo-


Volume 2, Issue 7

Healthcare Finance

By David Peel, Principal

David Peel and Associates

Many Washington State health-care organizations have had the same investment consultant since the inception of their organiza-tion. An investment consultant is an advisor who helps investors with their long-term investment planning. An investment consult-ant, unlike a broker, does more in-depth work on formulating cli-ents' investment strategies, help-ing them fulfill their needs and goals.

The consultant’s role is to evalu-ate an organization’s portfolio, investment policy and current fi-nancial situation and recommend a strategy to maximize yield and minimize risk consistent with the investment policy. The consult-ant may recommend funds, stocks, bonds or other financial instruments. It’s not unusual for a consultant to accept fiduciary li-ability. Compensation is either on a fixed fee basis or a percent-age of total asset balances.

In some cases, a founding Board member or member of the origi-nal management team brought in the consultant. While the consult-ant may have suited the organiza-

tion well during the organiza-tion’s start-up or early period, they may not be the best match now. Investment asset increases, environmental and risk tolerance changes and fee structures that aren’t appropriate given the or-ganization’s current state are sev-eral reasons why it’s best to peri-odically evaluate the effectiveness and efficiency of the current con-sultant through the request for proposal process (RFP).

Selecting a consultant should be done through the RFP process. Although necessary, this can be disruptive for the Finance depart-ment, Finance Committee and Board. If the RFP is done less than every five years, the result could be more costs in time and training than the benefits. If the RFP is done more than every five years, the result could be lower than expected service and yields due to too many years with the wrong consultant.

The RFP is issued to attempt to bring objectivity to the decision making process. If the responses are put into a spreadsheet and compared it is likely one or two will be superior to the others. A sample investment consultant RFP is available on the Washing-

ton Healthcare News website at www.wahcnews.com.

Changing portfolio balances

Many healthcare organizations experience large increases in their invested assets as they grow and mature. Larger balances allow greater diversification and the ability to tolerate higher levels of risk. A consultant focused solely on cash and money market funds, typical of start-up healthcare or-ganizations, may not have the di-verse experience needed to under-stand other types of investments like stocks, bonds and hybrids. Experience with larger investment portfolio balances is also impor-tant in many types of healthcare organizations given the regulatory environment. For example, health plans are prohibited from investing in certain types of in-vestments and are limited in the percentage of other types of in-vestments that make up their total invested assets. The consultant that understands the compliance issues involved with large in-vested asset balances is vital to many healthcare organizations.

Environmental changes

During most of the 2000’s,

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The Investment Consultant Request for Proposal: Why it’s Needed Every Five Years

Volume 2, Issue 7

Continued from prior page

there have been large swings in the investment returns of bonds and stocks. When the investment environment is volatile, as it has been, it’s even more important to hire a consultant with a broad range of investment experience. This is just as important with small asset balances as large bal-ances.

Changes in risk philosophy

Many Washington State health-care organizations are provider owned and governed. Provider owned organizations tend to have a conservative philosophy to-wards risk tolerance. As Sar-banes-Oxley has been adopted at many organizations, the percent-

age of non-providers on Finance Committees and Boards has in-creased. These new Board mem-bers frequently bring higher lev-els of risk tolerance consistent with their industry experience. As external Board members influ-ence the organization through their Board and Finance Commit-tee work, investment policies also change.

The consultant that has been with the organization for many years will be scrutinized for experience, prior relationships and perform-ance. Outside Board members that understand the importance of the investment portfolio’s per-formance on financial results de-mand “best in class” consultants.

This frequently means the long-term consultant is replaced by more capable consultants through the RFP process.

Investment consultant fees

Some consultants base their fee on a percentage of total assets. As assets grow, it’s important the fees are adjusted. Dan Yeung, CFA, Senior Investment Officer at Accessor Capital Management ([email protected]) com-ments, “The fee structure is usu-ally a percentage (usually ex-pressed as basis points) of initial portfolio assets and that percent-age drops as the size of portfolio assets increase. The reduced fee

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The Investment Consultant Request for Proposal: Why it’s Needed Every Five Years

With healthcare margins running as low as 1%, or even negative, it is incumbent upon both the CEO and CFO to be heavily involved in the process. The Finance Committee should also be active in the process and, at a minimum, interview the final two or three candidates. The Board should understand the proc-ess and meet and vote on the final candidate. A carefully constructed RFP issued every five years with staff, Finance Committee and Board involvement will go a long way towards helping meet every-one’s fiduciary responsibilities.

<The Investment

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in basis points is typically ap-plied to the incremental in-crease in assets.”

As organizations grow and bring in internal expertise, an investment consultant may not even be necessary. Duane Castles, Chairman and CEO of Prime Advisors, ([email protected]) a Redmond Washington based organization specializing in the management of fixed in-

come investment portfolios for the healthcare industry, notes “an in-vestment consultant should be re-viewed from time to time but full service investment managers can also provide these services and of-ten paying both fees doesn’t make sense.”

Concluding comments

It is frequently the CFO’s responsi-bility to initiate the investment con-sultant RFP. However, the CEO is accountable for overall financial results and should either initiate or be heavily involved in the process.

Volume 2, Issue 7

David Peel & Associates

Cost control strategies

Strategic planning

Network development

Feasibility studies

Business development

Interim CFO assignments

David Peel & Associates High Performance Healthcare Consulting

631 8th Avenue, Kirkland, WA 98033 | 425-577-3117

www.peelassociates.com | [email protected]

“Healthcare finance is frequently as much art as science. David Peel & Associ-ates consistently brings a network of the most experienced people Washington State has to offer to the table. We highly recommend this firm for those compa-nies seeking advice on controlling healthcare costs, strategic planning, feasibil-ity studies or network development”

Elizabeth Gilje

CEO

KPS Health Plans, Washington

Healthcare Real Estate Washington State Medical Office Building Listings

Property Name City Size (sf) Rate (NNN) Class Location/Features

Fairview Research Center Seattle 94,700 Negotiable B South Lake Union

Evergreen Plaza Kirkland 69,410 $22.50 B Adjacent to Evergreen Hospital

Olympus Medical Building Tacoma 45,000 $28.00 B Downtown Tacoma, near Allenmore

15th Ave. Professional Building Puyallup 44,000 $21.00 B Near Good Samaritan Hospital

Fed Way Center Federal Way 43,500 $25.00 A Adjacent to St. Francis Hospital

M Street Seattle 41,129 $32.50 A On First Hill near hospitals

Medical Dental Building Seattle 40,000 $17.00 B Downtown Seattle near Westlake

Bothel Professional Building Bothell 37,000 Negotiable B Fall 2007 completion

Yelm Medical Plaza Yelm 36,000 $28.50 A Proposed. Access to Hwy 507

Gig Harbor Urgent Care Gig Harbor 30,000 $24.70 B Built in 1990

14818 179th Avenue SE Monroe 26,104 Negotiable B Near Kelsey Place Retail Center

McMurray Medical Office Bldg. Seattle 25,123 $26.00 A Near Northwest hospital

Puyallup Medical Center Puyallup 22,000 $26.00 Near Good Samaritan Hospital

1717 Building Everett 20,000 $25.00 A On Providence Colby campus

Canterwood Business Park Gig Harbor 19,000 $20.00 Near St. Antony’s hospital

The Pathways @ Newcastle Newcastle 17,552 $26.00 B Proposed. Breaks ground in April

Jefferson Tower Seattle 17,292 $23.00 B On Swedish campus

3124 19th Tacoma 15,000 $24.00 A On Multicare/Allenmore campus

Allenmore Medical Office Tacoma 15,000 $25.00 A Adjacent to Allenmore hospital

Meridian South Prof. Center Kent 13,000 $26.00 A East Kent/Covington area

Dipankar Professional Center Kent 12,000 $25.00 A East Hill, Kent. Under construction

Union Avenue Medical Building Tacoma 10,600 $23.00 B Near Allenmore hospital

Newcastle Professional Center Newcastle 8,000 $26.00 B

Stevens Pavillon Edmonds 8,000 $23.50 A On Stevens hospital campus

Lilly Road Medical Office Bldg. Olympia 7,088 $23.75 A Completed in June 2005

Commons Professional Center Bellevue 6,397 $23.75 B Renovated projected near Overlake

Baze Professional Center Renton 6,050 $28.00 New construction

Bel-Red Medical/Dental Center Bellevue 5,735 Negotiable A Planned and permitted

Providence Rockefeller Bldg. Everett 5,000 $22.00 A On Providence Colby campus

Meridian Medical Building Seattle 6,474 $27.00 A Near Northwest hospital

Source: Grubb & Ellis Company, Commercial Broker’s Association and Costar. Includes both completed, under construction and proposed properties.

Volume 2, Issue 7

Interview with a Healthcare Leader

Jim Anderson is the President and CEO of Adaptis, Inc. (Adaptis), a Washington State based informa-tion technology company with a focus on the healthcare industry. This June 2007 interview was held in Seattle Washington.

Editor: What is your background and how did you come to take the President and CEO position of Adaptis?

Anderson: Like many of the healthcare leaders you have inter-viewed, my background is diverse and multi-faceted.

After I received my undergradu-ate degree, I worked for the US Army Intelligence in Germany. (I realize some would see an oxy-moron in the term “Army intelli-gence”). I was in Germany when the Berlin Wall was built and it was a “Cold War.”

I then worked for National Geo-graphic as an IT Programming Manager and attended Law School. I left National Geo-graphic and took a position at Sperry-Univac as an IT Project Leader. It was at Sperry-Univac that the experience I gained would change my life and help my decision to choose informa-tion technology over law as my choice of industries.

While at Sperry-Univac I was for-

tunate to work with John William Mauchly, one of the inventors of the first electronic digital com-puter and Grace Hopper, the in-ventor of the first compiler that allowed translation of English to computer machine language (COBOL). At Sperry-Univac, I was the project leader for the pro-totype of the first commercial on-line system.

One of my other major projects at Sperry-Univac was the work done on the NASA project to put a man on the moon. My portion of this ambitious project was to manage the communications network be-tween the multiple entities and locations participating in the pro-ject.

My next major position was as the Chief Information Officer of a large savings and loan based in California. I was subsequently recruited to become President, CEO and Chairman of the Board of the largest federal savings and loan in the Northwest.

I have been on the Board of Di-rectors for several healthcare or-ganizations and one of my fellow Board members asked me to be the President and CEO of Adaptis in 2000.

At the time, Adaptis was inter-nally focused with just one major client and functioned more as an

operating unit of a single client as opposed to an externally focused organization. The Adaptis Board asked me to turn the organization outward and diversify its client base. We have done that with the addition of several new products and the ability to offer the state-of-the-art QNXT healthcare applica-tion at a service level unmatched in the market and at a reasonable and predictable cost.

Editor: What are the principal products and services of Adaptis?

Anderson: Adaptis is a one -source solution for business proc-ess integration solutions for healthcare payers with 500,000 or fewer members. We offer:

A fully integrated IT platform for healthcare payers with claims, client and medical management functionality

Claims and client service out-sourced services at a predict-able, reasonable cost – some-times lower than payers can do internally

Credentialing

Utilization management

Disease management

Compliance services

Pharmacy benefit


An Interview with Jim Anderson, President and CEO of Adaptis, Inc.


management services

Fulfillment services

Subrogation and Recovery services

HEDIS related services

Health Risk Assessments

Editor: What are your plans for future products and services?

Anderson: One of the things that has always puzzled me is that healthcare organizations seem to react to past events but don’t do a very good job predicting future events.

Our clients tell us they could do a better job managing and control-ling costs if they could predict

them with more accuracy.

One of our biggest initiatives is to be in the position to offer our cli-ents predictive analytical solu-tions. For example, if a patient’s future claims could be predicted with a high degree of accuracy, more could be done to help that patient with the best path of treat-ment.

In addition to predictive analytics, we will be broadening our prod-uct lines to include support of commercial products and provide consumer directed healthcare ad-ministrative services.

Editor: What future technology applications will best support our healthcare system?

Anderson: Most healthcare or-ganizations receive service and technology solutions from multi-ple vendors. This means multiple service centers, software applica-tions and platforms.

So, it may not be as much about the types of solutions as it is how they are delivered to the client. With Adaptis, you have one ser-vice contact that will guide you through multiple services and so-lutions. This allows our health payer clients to focus on their core business – member care, pro-vider satisfaction - instead of wor-rying about vendors. Plus we es-tablish mutually agreed upon con-tractual service levels so the reas-surance of quality results is there.

Volume 2, Issue 7

By Paul Goldberg, MPH, PMP

Paul Goldberg & Associates, LLC

So, you thought the project could be completed by the end of the quarter? After all, how hard could it be to coordinate work across just two other depart-ments? But, four weeks into it, the manager leading the project wants to give up, other managers are frustrated, everyone has dif-ferent opinions on what needs to be done, and valuable resources are being used; all with no appar-ent progress. What went wrong?

Most health care organizations are structured by functional area with varying degrees of matrix responsibility. This environment of competing priorities and re-sources makes managing projects a challenging proposition.

Some common traps that doom a project from the start include:

Limited senior management support

Lack of clear objectives and poorly defined deliverables

Led by a manager with little project management experience

Participation on the project is a “favor” rather than a clear job responsibility

Project management tools de-signed by intuition rather than proven success

To avoid these traps, a well man-aged project should include strong sponsorship, a charter and scope, a dedicated project man-ager, and good product manage-ment tools.

A strong management sponsor is needed to supply project re-sources and champion the project among key management stake-holders. This is who the project manager can turn to if there are problems needing management resolution.

A project charter document is needed to authorize the project, its objectives, and the project manager. And, a scope document is critical to clearly state what is to be accomplished and includes such information as: project boundaries, assumptions, con-straints, requirements, deliver-ables, milestones, cost estimates, and risks. These documents don’t need to be dissertations, but they do need enough specificity to pro-vide a common understanding about the project among all stake-holders.

A single dedicated project man-ager accountable for project suc-cess must be assigned. Being a good functional line manager, does not necessarily translate to being a good project manager; project management is by influ-

ence and negotiation, rather than direct authority. And often times, functional managers are too busy with their daily responsibilities to manage complex projects. In these cases, organizations have a number of options:

Provide line managers project management training and tempo-rarily reassign other responsibili-ties

Seek support from the organi-zation’s project management of-fice (PMO) that houses a pool of project managers

Hire an external resource with project management expertise in health care

Good product management tools to manage project activities are essential. Too often, however, project managers design their own tools based on intuition and don’t use ones already proven to be successful. This can have a significant impact on project out-comes. Good tools include not only work plans and issues logs, but also those related to commu-nications, schedules, costs, risks, quality and performance.

Sometimes a project managed by a functional manager with neither the training nor tools is successful with good intuition, sheer will,


Healthcare Administration Managing a Successful Project

Volume 2, Issue 7


and an Excel spreadsheet.

However, when projects are large, complex and critical to organiza-tional objectives, the use of a proper project management struc-ture and approach truly enhances the opportunity for success.

Paul Goldberg has over 20 years managing projects in numerous health care organizations. He has a Masters in Public Health from Yale University and a Pro-ject Management Professional (PMP) certificate from the Pro-ject Management Institute. Paul is Principal at Paul Goldberg &

Associates, LLC a consulting company providing project lead-ership to health care and health related businesses.

Visit pgoldbergconsulting.com to learn more or contact Paul at [email protected] or 206-372-5158.

August 2007 September 2007 October 2007 November 2007 December 2007

Theme: Ancillary Services

Advertising Space Reservation:

July 6, 2007

Theme: 2008 In-surance Products


August 3, 2007

Theme: Commu-nity Health Centers


September 7, 2007

Theme: Hospitals


October 5, 2007

Theme: Associa-tions


November 2, 2007

Washington Healthcare News 2007 Editorial Calendar

projected growth of the U.S. economy.

Of course, employers and con-sumers are seeing their health-care costs rise even faster – due to a “hidden tax” created when un-derpayments by Medicare and Medicaid drive providers to the private sector to make up the dif-ference. That cost-shift must stop.

Still, in the final accounting, the difference between health-care sustainability and failure is just 2 percent per year. That is where I find great hope.

I believe we can achieve this without harming medical innova-tion and quality -- and without spending cuts. The keys: taking more responsibility for our own health and using our health-care dollars smarter.

The Age of Big Medicine must ascend to the Age of Accountabil-ity. Finger-pointing and hand-wringing must end. We must set a clear, reasonable goal and exer-cise the national will to get there.

We can and will find that 2 per-cent through healthier lifestyles; evidence-based medicine; and comparative cost-effectiveness studies on all treatments, drugs and devices.


make the difference. For example, one in three American adults has cardiovascular disease – the sin-gle greatest cost in health care today. Nine in 10 initial heart attacks are preventable.

This isn’t the road to better health. It’s the road to economic disaster.

In the 1970s, health care ac-counted for about 8 percent of GDP. Today, we’re all aware it’s up to 16 percent, or $2 trillion – and doubling to $4 trillion by 2015.

In the short run, that’s painful. In the long run, it’s unsustainable.

Based on current projections, the funding gap for Medicare alone stands at $74 trillion – looming seven times larger than the Social Security crisis.

Medicare consumes 20 percent of today’s federal government spending, but by the early 2040’s, Medicare will take it all, crippling the federal budget or requiring massive tax increases.

Ironically, we are being over-whelmed at the rate of just 2 per-cent per year. Two percent.

That’s the difference between the 6 percent projected growth rate of national health-care costs and the

By Gubby Barlow

Health-care advances during the past century are little short of miraculous. More years have been added to our lives in the past 100 years than in the pre-ceding 40,000.

Americans born today will live an average of 78 years – three decades longer than children born a century ago.

We are living longer, but we are living longer with chronic condi-tions, and increasing health-care spending at a rate sure to bank-rupt our children and grandchil-dren. We have a moral impera-tive to change – not just for our-selves, but for our future genera-tions.

I believe we also have the means to do so.

During the first half of the 20th Century, Americans increased their average lifespan by 20 years, to age 67. That was the Age of Public Health, driven by the lessons of soap, sanitation and antibiotics.

The past half-century -- the Age of Big Medicine -- gave us an-other 11 years. We are eating more, exercising less, enduring greater stress – and relying on medicine and technology to

Healthcare Opinion

The Difference Between Success and Failure is 2% a Year


The Centers for Disease Control says we spend three-quarters of our health-care budget treating chronic conditions like heart dis-ease and diabetes. Both are highly influenced by lifestyle. One national study estimates that 25 percent of medical costs are linked to lifestyle. Others say that’s conservative.

At Premera, we started a “Know your Numbers” campaign – mobi-lizing our employees to know and improve their own key health in-dicators such as blood pressure, cholesterol, body mass index, and blood sugar. My own numbers aren’t bad, but they could be bet-ter. My doctor says they give me

a 10 percent risk of death in the next 10 years versus about 3 per-cent if my numbers were ideal.

So, I am learning to love oatmeal.

Second, we need to recognize that more care is not necessarily better care. The amount of health care delivered in some regions of the country varies spectacularly with no appreciable difference in life-span or quality of life. The well-known Dartmouth studies suggest we could save up to 30 percent of health-care costs by adopting ex-isting best practices.

Third, today’s health-care ‘best practices’ might be even better, if medicine had the benefit of com-parative effectiveness studies that

make it possible to know and pay for what works best.

Remember, we don’t need to cap-ture all of these savings at once. All we need is 2 percent a year to keep health-care spending growth in line with the overall economy.

It is time to set a goal of getting our two-percent’s worth of pre-vention and savings each year.

We should do it for ourselves. More importantly, we must do it for our children.

Gubby Barlow is the CEO of Premera Blue Cross, recognized in 2007 by J.D. Power & Associ-ates for delivering the highest member satisfaction in the west-ern U.S.

Volume 2, Issue 7

Career Opportunities To Advertise call: 425-577-1334

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We offer a competitive salary and benefits package. For immediate considera-tion, please send resume and cover letter to [email protected] or fax to 206-933-7005.

EOE

Chief Operating Officer (COO) Okanogan Behavioral HealthCare and Medical Clinic (OBHC) is a cutting edge Community Behavioral Health and Primary Medical Clinic located in North Central Washington. OBHC is seeking an experienced and highly successful senior leader to join a dynamic man-agement team. Okanogan Behavioral HealthCare and Medical Clinic (OBHC) is an $8.7m progressive system poised to continue its steady growth in order to meet the needs of its citizens. An "Ideal" candidate should be: an experienced senior behavioral health operations execu-tive who is also strategic minded, entrepreneurial and creative; have the ability to ensure infrastructure and systems are in place to guarantee continued program growth; an excellent communicator and accessible to staff; a strong manager with a mentorship and coaching philosophy; passionate about the mission of integrated health care while being equally passionate about the business side of the organization; a self-starter with a strong commitment to "team", and be comfortable work-ing in a complex health care environment with a lot of regulatory demands and expectations. This COO will oversee all clinical and program operations across the entire organization, supervise and direct Divi-sion Directors as well as oversee the development and implementation of all system policies/procedures related to care delivery; will have direct P & L responsibility for program operations; will be a critical liaison to regulatory and funding agencies and the community in general; will be intimately involved in the integration of administrative operations with programs and services; will ensure that best practices of care delivery are in place; and will be instrumental in the development and implementation of the organization’s strategic plan. Must have knowledge of primary medicine, an understanding of fee-for-service reimbursement models, a commitment to the integration and collaboration of behavioral health and primary medi-cine, a commitment to community based care, and a strong clinical/programmatic grounding. Requirements: Masters in behavioral health field, with a strong preference for having a clinical background (Ph.D., LCSW, ARNP, MSN, LPC, LMFT) 10 years of senior management experience in a complex health care setting Experience with JCAHO, Knowledge of Primary Medicine & Behavioral Health Integration, Medicare/Medicaid reim-bursement processes, contract and grant financial fund-ing; preference given to those who might have gone through accreditation and a reimbursement change to a fee for service environment. Competitive compensation plan with excellent benefits! Contact: Heather Fuhrman, Director of Employee Rela-tions [email protected] 1007 Koala Dr. Omak, WA 98841 (509) 826-6191

OBHC is an equal opportunity employer

Volume 2, Issue 7

YTD Net Income and Members through 03/31/07 for the Largest Health Plans in Washington State (1)

Plan Name Net Income Members Plan Name Net Income Members

Health Plans: LifeWise HP of AZ. (3) ($3,784,697) 28,660

Regence BlueShield $16,295,637 949,623 Arcadian Health Plan ($4,700,636) 18,077

Premera Blue Cross $43,294,500 720,561 Timber Prod. Manuf. Trust $128,819 10,098

Group Health Cooperative $49,019,147 410,404 Washington Employers Trust ($1,185,294) 8,995

Molina Healthcare of WA $9,677,559 286,746 Aetna Health, Inc. $1,033,801 7,350

Community HP of WA $4,460,282 231,285 Washington State Auto Ins. $359,990 3,984

Group Health Options $246,626 98,178 Puget Sound Health Partners ($191,293) 0

Asuris Northwest Health $473,242 88,752 Vision or Dental Plans:

LifeWise Health Plan of WA ($675,357) 84,183 Washington Dental Service $2,736,188 895,137

Pacificare $12,431,832 53,207 Vision Service Plan $1,813,757 522,914

KPS Health Plans ($1,228,209) 44,545 Willamette Dental $160,967 68,555

YTD Margin and Days through 12/31/06 for the Largest Hospitals in Washington State (2)

Hospital Name Margin Days Hospital Name Margin Days

Swedish Medical Center $83,492,143 147,498 St. Joseph Hospital Bellingham $10,386,583 57,857

Sacred Heart Medical Center $40,947,507 143,024 Good Samaritan Comm Health $18,950,716 51,828

Harborview Medical Center $16,669,000 131,582 Valley Medical Center $17,969,021 50,570

University of WA Med Ctr. $23,815,691 106,405 Evergreen Hospital Med Center $15,157,719 49,466

Providence Everett Med Ctr. $38,671,351 95,236 Highline Community Hospital $7,926,729 47,257

St. Joseph Medical Center $53,149,636 90,967 Yakima Valley Memorial $8,337,576 46,962

Southwest WA Med Ctr. $22,253,044 86,759 Swedish Cherry Hill Campus ($7,022,263) 40,715

Virginia Mason Medical Ctr. $13,208,499 82,839 Kadlec Medical Center $1,291,150 40,574

Tacoma General Allenmore $55,467,207 81,127 Holy Family Hospital $12,423,687 39,659

1. Source: WA State OIC. 2. Source: WA State DOH 3. LifeWise Health Plan of AZ’s enrollment is in Arizona.

Providence St. Peter Hospital $31,545,494 80,914 Central Washington Hospital $12,833,960 39,487

Deaconess Medical Center $6,027,242 68,052 Northwest Hospital $6,234,899 39,125

Harrison Medical Center $8,540,280 61,415 North Valley Hospital ($488,584) 29,924

Children’s Hospital $28,335,004 66,651 Peacehealth St. John Med Ctr $22,290,615 36,325

Overlake Hospital Med. Ctr. $20,273,333 62,149 Stevens Healthcare $463,806 33,614

Columbia United Providers $43,375 35,508 Dental Health Services ($145,206) 25,048

Plan and Hospital Financial Information

Washington Healthcare News 631 8th Avenue Kirkland, WA 98033 David Peel, Editor Elizabeth Peel, Production & Distribution For Advertising and Inquiries: Phone: 425-577-1334 Fax: 425-242-0452 E-mail: [email protected] Visit us on the web at:

www.wahcnews.com Washington Healthcare News is published monthly by David Peel & Associates, a Washington based healthcare consulting firm specializing in cost control strategies, strategic planning, network development, feasibility studies, business development and interim CFO assignments. Reproduction without permission is strictly prohibited.

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