The health care industry here expects to remain in a state of transition in the coming year as it continues to adapt to broad implementation of the federal Affordable Care Act. 

Industry executives say they are seeing some positives from a larger insured population, but indicate it’s too early to see definitive results from the first year of the federal program. The program is currently in its second open enrollment, which runs through Feb. 15.

Bill Akers, vice president and general manager of the Spokane operations of Mountlake Terrace, Wash.-based Premera Blue Cross, says the company is performing well, and is on track from a budget perspective. 

“We continue to grow in all markets,” Akers says. 

Delivery systems and access to health care are the critical concerns in health care, Akers says, and he believes there will be innovative changes as a result of the ACA and by having a larger group of insured consumers. 

“I think we’ve seen physicians practicing at a level below their licensing function, and I think we’ll see physicians practicing at the top level of their licenses,” he says.

He adds that it may mean more advanced registered nurse practitioners and registered nurses will become primary health care providers. Akers believes virtual health care will be a much bigger part of the health care landscape in the future in areas such as remote consultations, electronic personal health records and other forms of “telehealth.” 

Primary providers may change as well, he says.

“I think we’ll be having more independent practices with an increase in the scope of services they provide,” he says. “We need everyone to do as much as they can do. They’re trained and talented and we should take advantage of the full scope of their training.” 

If expansions at current medical centers are any indication, Spokane is doing well and expectations are high for the future. 

Spokane-based Providence Health Care, which operates the Inland Northwest’s largest health care network, this year finished building a $58 million medical center in Spokane Valley, which it expects will greatly expand outpatient services there.  It also wrapped up a $9.5 million expansion and remodel of the maternity center at Providence Holy Family Hospital on Spokane’s North side.

Providence Sacred Heart Medical Center & Children’s Hospital announced in July that it’s planning a $19.2 million expansion and remodel of its adult cardiac intensive care unit, which is to be completed in spring of 2016.

The project will add 12 critical-care beds to the unit, giving it a total of 34 beds there, in its first phase. The second phase involves modernizing the current, 22-bed unit. Sacred Heart plans to install new monitoring devices and other, more mobile equipment throughout the unit. Once the expansion and modernization are complete, the hospital says it expects to hire more critical-care nurses there.

CareUnity, an accountable-care organization established two years ago by Group Health Cooperative and Providence, hired Dr. Jeffrey Liles as its first chief medical officer in October. Liles is an internal medicine physician who says he plans to address lowering costs, increasing patient satisfaction, and improving quality of care. CareUnity said in July that it is starting to see care delivery improvements from the collaboration.

Spokane-based Mann-Grandstaff Veteran Affairs Medical Center is in the design stages of a $10 million primary care clinic to be built on the hospital campus northwest of the city. Dr. Rob Riddle, VAMC’s chief of ambulatory services, says the 25,000-square-foot clinic is planned to accommodate what the VA refers to as its new patient-aligned care team focus. Riddle says the Spokane VAMC plans to add another physician-nurse provider team in 2015, and two more when the new clinic comes online. 

Community Health Association of Spokane, a Spokane-based nonprofit health services provider, has bought a multitenant building in Spokane Valley and plans to open its second Valley clinic in a 6,000-square-foot portion of that building. CHAS currently operates 10 clinics in the Inland Northwest, including four in Spokane, one in Spokane Valley, and one in Deer Park. 

Inland Northwest Health Services, the big employer here that provides a range of health care-related service, is financially healthy and continuing to grow heading into the new year, said Tom Fritz, its soon-to-retire CEO, in a recently published interview with the Journal. INHS, which operates St. Luke’s Rehabilitation Institute; Northwest MedStar, a critical care transport service; and other health-care entities, has more than 1,100 employees. 

INHS has seen incremental growth over the past 16 years, with the expansion of MedStar, its growing role in  information resource management, and management of St. Luke’s. 

Pathology Associates Medical Laboratories, the Spokane-based national reference laboratory that also is among Spokane’s largest employers, this year launched Cinch, an at-home blood collection kit for consumers. The Cinch line merged with PAML’s existing mail-order system called Results Direct, which enables customers to go online and order testing products and then go to a designated collection clinic to have their blood drawn. With Cinch, PAML says customers use a finger stick to produce a spot of blood, which is then absorbed on special paper and sent back to PAML for testing.

—Judith Spitzer