Those of us in the business-and-technology prognostication game are forever trying to see around corners, over the horizon and through the fog of the future, to catch a glimpse of the next big trend.
No one wants to be the one who dismissed some invention or start-up as a failure or a fantasy, only to have it reshape its sector and how people live their lives.
But there’s also an occupational hazard in the other direction: Hailing some idea or development, only to have it sputter out.
Such is the case with health-care clinic operator Qliance.
Never miss a local story.
We wrote about Qliance and what it was proposing to do in this space five years ago. The company set up a series of clinics in the region –including one in Tacoma – to provide primary care and basic medical services for a monthly fee.
The approach was meant to address some of the many complaints about the existing fee-for-service health-care system, including the need to generate revenue by churning through lots of patient appointments quickly.
To entice employers battered by escalating health-care benefit costs, Qliance suggested offering one of its plans combined with an insurance plan to cover surgeries, disease treatment and other medical events often termed “catastrophic.”
Qliance added another level of innovation, by setting up clinics adjacent to big employers (they could be used by Qliance clients employed elsewhere). Its first was at the Bellevue headquarters of the travel-booking website Expedia.
As recently as July, Qliance announced an affiliation with the Seattle Fire Department, locating one of its clinics at a downtown fire station to provide primary care and occupational health services.
The theory was that not only would employers save money on direct health-care costs, they’d also get productivity gains, because employees would spend less time away from work getting to and from and waiting on appointments. They might even get healthier employees.
Such promises were like catnip to pundits like this one.
“If this stuff works as hoped and the employer and consumer markets like what they’re getting and ask for more,” that 2012 column speculated, “it could well turn out that the politicians will one day look up from their wrangling over health care, only to find that while they were fighting, consumers and providers went ahead and solved the problems on their own.”
The politicians are wrangling even more vociferously over health care these days. As for market-generated solutions, we eventually might get them, but Qliance won’t be among them.
The company abruptly closed up shop earlier this month, leaving patients scrambling to line up doctors for exams and prescription refills.
“Despite all our efforts, we have found that the more we grew and proved that this really works, the more the system resisted us and made it harder and harder to survive,” said Dr. Erika Bliss, Qliance’s chief executive.
“It’s not surprising, given that the health-care industry represents 19 percent of the GDP of this country – that represents entities with a lot of money and power that are not about to give those up without a fight.”
The coming weeks and months will show whether the model was irretrievably flawed or under attack from entrenched interests, or whether the models will work for someone other than Qliance.
Bliss wrote that she and other Qliance doctors will be starting independent practices, with a suggestion that elements of the Qliance model will be part of those new practices.
Interestingly, another company mentioned in that column, Paladina Health (a subsidiary of DaVita Inc.), operates on much the same model.
“Our physicians are paid a flat salary and incentivized through bonuses on health outcomes, patient engagement and patient satisfaction,” the company’s website says. “It’s their job to deliver the best care, not the most care. And, by eliminating co-pays and co-insurance, we remove barriers to care—patients are able to use the service as much or as little as they need.”
To the Tacoma clinic it operated then, Paladina has added locations in Puyallup and Federal Way.
The on-site health-care clinic concept hasn’t faded either.
Urgent-care and in-store clinics, designed to help consumers avoid expensive and crowded emergency rooms for routine medical procedures and treatment of minor injuries and illnesses, continue to proliferate.
And even as Qliance sinks, health-care ventures continue to spring up, their entrepreneurial sponsors sure that this time they’ve got the prescription to cure the system’s ills.
Whether they do will be tested by continuing issues that include industry consolidation and the future of federal and state-government health insurance plans and laws.
We’ll continue to track the new models’ success, mindful of the most recent reminder that when it comes to proposed solutions for problems, false positives are a common occurrence.
Bill Virgin is editor and publisher of Washington Manufacturing Alert and Pacific Northwest Rail News. He can be reached at firstname.lastname@example.org.