Changes under way in county for health care reforms

Local medical groups aren’t waiting for 2014, the year big changes are scheduled with the federal health care law, to make changes of their own.

Providence Everett Healthcare Clinic, a nonprofit clinic for low-income, uninsured and Medicaid patients in north Everett, will open in new, bigger quarters on the Everett Community College campus next year, said Dave Brooks, chief executive of Providence Regional Medical Center Everett.

The 20-room clinic is expected to open in June 2013. The current clinic, on Broadway, now serves about 250 patients a week. The new clinic will have the weekly capacity to treat 400 patients.

The clinic will be on the first floor of the college’s new health sciences building, which is now under construction, Brooks said.

“We’ll keep that practice there for decades to come and expand even further,” he said.

In addition, EvCC students pursuing degrees in nursing and other health professions will be able to get practical experience at the clinic, Brooks said.

Another effort has The Everett Clinic expanding a program first tested with Boeing employees to try to provide better care at reduced costs to people with chronic health problems.

It’s one local example of a national goal: providing better care for patients while reducing health care costs.

The program was first tested with 220 Boeing employees who had a variety of serious health problems and volunteered to participate in the pilot program.

Their health issues included diabetes, high blood pressure, mental health issues and prior heart attacks, said Dr. Harold Dash, a cardiologist and the organization’s president.

The program was able to cut their health care costs by 20 percent by taking steps such as reducing the number of times they went to the emergency room or were hospitalized, he said.

Instead, they had direct phone and email access to a nurse, who would coordinate their care and ensure they could get same-day medical treatment when necessary, Dash said.

In the past, delays in getting care often caused these patients to seek treatment in emergency rooms, where care is more expensive and follow-up care can be hit-or-miss.

The Everett Clinic is using lessons learned from that demonstration project as a model to better coordinate care for some 2,500 of its current patients, he said.

“We recognize this is just a percentage of the patients who need this type of care,” Dash said.

The next big change consumers will see from the federal health care law, both in Washington and nationally, is scheduled to occur in 2014.

That’s when individuals and families who want to buy health insurance can begin using an online system somewhat like shopping for consumer items like cars, clothes and camping gear, to compare health insurance plans.

Individuals making a maximum of $43,000 or a family of four with a maximum income of $80,000 can qualify for subsidies to help pay for insurance, said Diana Rakow, Group Health’s executive director of public policy and government relations.

Consumers will be able to choose from plans that are cheaper with more out-of-pocket costs, such as deductibles and co-pays, or more expensive plans with fewer of these charges.

Borrowing terminology from sports competitions, these plans will be called bronze, silver, gold and platinum plans.

“You wind up with health insurers that have to compete on service, quality and price,” said state Insurance Commissioner Mike Kreidler.

Kreidler said one of his biggest concerns is trying to get as many people as possible who don’t have insurance to sign up.

“The last thing you want is someone staying out of the system until they have a health problem and then sign up for it,” he said. “It’s like homeowners who say I won’t buy homeowners insurance until my house is on fire.”

To keep insurance systems economically strong, “you need people paying into it when they’re healthy a well as when they’re sick,” he said.

Brooks, the Everett hospital’s chief executive, said his concern with the new law is that the public could be lulled into thinking that the problems with access to health care, particularly with low- and moderate-income children and adults, are taken care of.

“I worry about everybody saying now that we solved that issue, let’s tackle something else,” Brooks said.

“The health care system in America is very broken right now,” he said. “This goes toward repairing it, but it’s not the single repair.”

One health care organization, Stanwood’s Safe Harbor Free Clinic, doesn’t expect that the federal health care law will put it out of business, even with its emphasis on getting many more people insured.

Typically, about 40 patients come to the clinic during its weekly Friday evening hours. “We’re having to turn patients away,” said Julie Vess, executive director. “We don’t have the capacity to meet all the needs of the patients.”

Vess said she’s concerned that some patients will make too much money to qualify for the expanded Medicaid programs included in the health care law, but they won’t be able to afford the cost of even basic health insurance that will be available.

“We’ll be here to treat people with great care just like we always have, even after 2014,” she said. “There will still be people who need our services. That’s not going to change.”

Sharon Salyer: 425-339-3486 or

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