Inland Northwest Health Services, of Spokane, expects to pursue more growth opportunities with Providence Health Care next year, once that organization is its only member.

    Meanwhile, Providence is viewing INHS as a key piece in its evolution from a hospital system to a comprehensive health system.

    "With the ACA (Affordable Care Act), it's driving people to realize you can't work in silos anymore," says Elaine Couture, Spokane-based regional chief executive of Providence.  "You have to be part of something bigger to really lower your costs."

    Providence announced it would become the lone member of INHS last month after Empire Health Foundation agreed to discontinue its role in the organization. At the same time, Providence agreed to donate $40 million to the foundation, which nearly doubles the size of its endowment and will play a key part in its plan to triple its giving next year (see related story, page 23).

    Providence plans to make that donation to the foundation before Christmas, Couture says. Early in the new year, she and INHS CEO Tom Fritz say they will start looking for replacements to fill the three board positions that foundation representatives will vacate and to look at ways that INHS can expand its presence in the Providence network.

    Fritz says, however, that INHS has a strong strategic plan in place and that the board is strong with the members that remain.

    Consequently, he says, in the new year, "The first order of business will be the business at hand."

    INHS, which operates as a nonprofit organization, had $200.1 million in revenue last year and a 5.5 percent net margin, or net income, says spokeswoman Nicole Stewart. The company is hoping to finish this year with comparable results, she says.

    The organization currently employs about 870 people in all, 840 of whom are in Spokane County. That's up from about 820 employees a year ago, about 790 of whom were here.

    Fritz says the organization's three main divisions—information resource management, Northwest MedStar (see related story, page 27), and St. Luke's Rehabilitation Institute—generate equal amounts of income for the organization and have been growing at roughly the same rate.

    He says, however, the information-resource management division has the most potential to expand its presence within the Providence network beyond Eastern Washington. That division consults for health-care providers on electronic health-records system and provides system implementation and management services.

    Spokane-based Providence Health Care is part of a larger, regional network, Providence Health & Services, which includes 29 hospitals and more than 400 clinics in five Western U.S. states. It went live in Eastern Washington last month with the Epic Systems Corp. electronic records system as part of an $800 million systemwide rollout. Fritz says Epic is one of the systems with which INHS is able to work, describing it as one of many tools the organization can use in working with clients, in addition to other electronic records systems with which it's familiar.

    Couture agrees that the information resource management system has the most potential for growth.

    "In the end, it's not about INHS becoming an Epic shop. It's about, how do we leverage INHS to better take systems and structures into our health care system," she says.

    Couture and Fritz say they will meet next year to look more specifically at how that growth might occur.

    Empire Health Foundation representatives that have held positions on the board include foundation President Antony Chiang; Dr. Deb Harper, of Group Health Cooperative; and Dr. Matt Layton, of the University of Washington.

    Other members include health care professionals Dr. Jeff Collins, chief medical officer of Providence Health Care, and Terry Smith, senior vice president of management services at Providence Health & Services. Community at-large members of the board include Spokane developer Ron Wells, who currently serves as board chairman; Gary Livingston, retired chancellor of the Community Colleges of Spokane; and Mike Reilly, who is retired from Mercer Health & Benefits.

    Fritz and Couture say they will evaluate candidates for the open board positions next year and haven't set a timeline for filling those positions yet.

    INHS formed in 1994 as a collaboration between the Spokane area's four major hospitals to oversee Northwest MedStar and St. Luke's Rehabilitation Hospital. Since then, the organization has grown to develop its now-prevalent information resource management division as well as other initiatives, including Northwest TeleHealth, Center of Occupational Health & Education, community wellness, and health education, among others.

    Empire Health Foundation formed after Spokane-based nonprofit Empire Health Services, which operated Deaconess Hospital and Valley Hospital, sold its assets to for-profit Community Health Systems Inc., of Franklin, Tenn. The foundation became part owner of INHS after that transition.

    Being involved in INHS never was central to the health foundation's mission, and all three parties had been talking for a number of months about the foundation's departure.

    Couture says, "I think Providence and Empire Health Foundation always knew there would be a time that this would occur. It wasn't a matter of if. It was a matter of when. We decided this would be when."