After months of discussion and preliminary evaluation, Cancer Care Northwest, Providence Health Care, and Kootenai Health are getting close to launching a regional cancer alliance that they believe will advance cancer research and improve patient care here.

The three big health care providers announced four months ago that they had signed a memorandum of understanding to form the alliance. Warren Benincosa, Cancer Care Northwest's CEO, says that since then they have been working their way through a several-step process that has included looking more closely at the potential benefits from such a collaboration, how it might be structured, and whether it's financially feasible.

Alliance members now are in a final phase of developing a detailed plan, or pro forma, for the alliance, Benincosa says, adding, "I think that's the last hurdle before we sign the papers and move forward."

He says he expects that to occur within the next couple of weeks.

"We still have to work out who's going where and that sort of thing" in terms of relocating providers and support staff to meet the needs of the alliance, but those details should become clearer soon, he says.

By combining their expertise, the alliance members hope to create more standardized care and coordinated treatment for patients, thereby hopefully improving clinical outcomes and elevating the overall level of care, while also hopefully creating some cost efficiencies, Benincosa says.

The alliance's first endeavor will be to create a comprehensive and integrated radiation treatment program for patients, he says, adding that Cancer Care Northwest will be "the managing member of the radiation oncology piece."

In a news release last May about the signing of the memorandum of understanding, the alliance members said the intent "is to develop one coordinated radiation oncology program across the three organizations creating greater efficiencies and improved access to advanced, targeted radiation tools that enhance treatment response and minimize side effects."

If all goes well with that initial radiation oncology piece, the alliance members expect to begin formulating similar plans for collaboration in the areas of medical oncology and surgical oncology, Benincosa says. They started with radiation oncology, he says, because it was the least complex of the three in terms of developing and implementing a collaborative model.

The alliance will have an initial total of 39 providers, including 27 oncologists and 12 advanced-practice professionals such as nurse practitioners and physician assistants. Between them, the alliance members currently operate a total of nine linear accelerators, which are the high-cost machines used to deliver radiation dosages in cancer treatments.

As for the alliance operation, Benincosa says, "It will be billed and managed and run by us."

Cancer Care Northwest is a physician-owned oncology practice that has operated in Spokane for more than 30 years. It's comprised of 22 physicians and eight mid-level providers, specializing in medical, surgical, radiation, and gynecologic oncology, and now employs more than 230 people, up from about 180 a year ago.

It currently operates four clinics in the Spokane area and seven outreach clinics throughout Eastern Washington, and will open on Oct. 7 a new $14 million multispecialty clinic in Spokane Valley. The 37,000-square-foot clinic, now in the final stages of completion, is located on a 5.4-acre site at 1204 N. Vercler, southeast of Valley Hospital.

Cancer Care Northwest will move its current Valley clinic practice to the new location from 12615 N. Mission, just north of Valley Hospital, where it leases 10,000 square feet of space. Meanwhile, its administrative offices will move there from a 9,000-square-foot building at 5105 E. Third that it also leases.

The new clinic will provide some services that Cancer Care Northwest doesn't currently offer in the Valley, including radiation oncology.

Spokane-based Blue Room Architecture & Design PS designed the project, and Bouten Construction Co., of Spokane, has been the general contractor.

Scott O'Brien, Providence Health Care's chief of strategy and one of the people heavily involved in the negotiations to create the alliance, says he's excited about its pending formation.

It's been driven in part, O'Brien says, by independent market forces "pushing us to a place where working together makes more sense than not working together."

Providence Health Care, the Spokane-based regional network, operates Providence Sacred Heart Medical Center & Children's Hospital and Providence Holy Family Hospital, both in Spokane, as well as a number of other hospitals, health-care facilities, and organizations in Eastern Washington.

Providence Medical Group, the physician division of Providence Health Care, includes more than 400 primary-care, specialty-care, and hospital-based care providers serving patients in Washington, Idaho, Montana, and Oregon.

In the press release announcing plans for the alliance, Providence Health Care CEO Elaine Couture called the collaboration "one of the most exciting health care opportunities we've seen."

Kootenai Health CEO Jon Ness, meanwhile, described it in the news release as an outgrowth of higher expectations by patients, medical providers, government agencies, insurance companies, and health plans.

Kootenai Health is based in Coeur d'Alene and includes a 254-bed, community-owned hospital and specialized services for cancer, heart, and neonatal care; diagnostic imaging; and rehabilitation. It has formed affiliations with three critical-access hospitals in northern Idaho and employs more than 75 primary and specialty-care physicians in clinics throughout the region.

This isn't the first time these alliance partners have worked together in different combinations. Cancer Care Northwest and Providence Sacred Heart already have been working together to expand a program for treating patients with blood cancers, including leukemia and myelomas, the earlier press release said, and O'Brien says Providence and Kootenai Health have had a partnership in radiation oncology. The alliance is viewed, though, as much farther reaching and having potentially broader benefits that those prior collaborations.

Benincosa says another factor behind the creation of the cancer care alliance is that "we have competition, and we wanted to plant our flag." In the case of Cancer Care Northwest, he says, "We realized we needed a tertiary partner" if it was going to establish the kind of regional presence it desired.

Cancer Care Northwest has invited all patients and the community to visit its new valley clinic on Thursday, Sept. 26, at 4:30 p.m., for a preliminary tour and ribbon-cutting ceremony.