Business Columns & Blogs

Higher education and health care are changing with the times

Let’s cull a few recent news items about two of the region’s important sectors — health care and education — and see if we can deduce some trends and directions from them.

Item: Tacoma-based MultiCare Health Systems has signed an affiliation agreement with Grays Harbor Community Hospital.

Item: UW Medicine has signed an affiliation agreement with PeaceHealth, based in Vancouver, Wash., and operating in Washington, Oregon and Alaska.

Item: Franciscan Health System, also Tacoma-based, has completed the previously announced alliance with Highline Hospital in Burien.

Item: UW will be offering MOOCs — massive open online courses, free and open to the public — through edX, a consortium led by Harvard and MIT.

Item: Brian Baird, former congressional representative from southwestern Washington, has been named the new president of Antioch University Seattle.

Item: At a recent meeting of the Washington State Board for Community and Technical Colleges, members had on the agenda applications from Columbia Basin, Highline, South Seattle, Lake Washington Institute of Technology, Seattle Central, North Seattle, Green River to set up new four-year degree programs.

There’s more where those came from, but this is enough to work with.

What we can safely conclude from the accumulation of these news items, at least as far as the trend, is that two sectors thought to be tradition-bound and slow-moving are in fact being radically remade; the names of the players providing the services in those industries, and the channels, locations and methods they employ to deliver those services may have stayed fairly constant for decades, but they are likely to be significantly different less than a decade from now.

As for the direction of those trends — no one knows for sure, least of all the institutions, organizations and companies in the thick of them. But they know things are changing, and they suspect that whatever change leads to, the traditional operating structures won’t be up to dealing with the new reality.

For the health care industry, the obvious, if murky in detail, change headed its way is Obamacare, but that’s only part of the story. Well before that bit of legislation, those in the health care sector knew looming problems such as an aging population and increasing demand for services, coupled with continued cost inflation, would force the industry to change. The favored defensive coping mechanism of the moment is to join up and bulk up, building larger, integrated networks through combinations ranging from loose affiliations (such as MultiCare-Grays Harbor, in which participants retain their independence) to outright mergers and acquisitions.

The UW-PeaceHealth join-up, for example, offers the opportunity for more training outlets for UW medical students, while UW also becomes a preferred provider of complex, high-level services for PeaceHealth.

Keeping more patient revenue within one system through referrals is one financial motivator for these deals. Another is that these networks might be able to squeeze a few more dollars out of costs, a task the health care industry has had at best sporadic success at.

Cost is a big issue in higher ed, too, and a reason for much of the change in that sector. It’s been highlighted by stories of the debt loads students have accumulated with little hope of repaying even if they manage to land jobs after graduation, which, thanks to the recession, has been even more difficult than normal. You don’t have to search long or hard to find plenty of articles on the theme of “Is the cost of college worth it?” Nor do you have to search long to find plenty of parents and students answering in the negative.

That’s provided an opening for the community and technical colleges, for whom the label “two-year colleges” is increasingly incomplete, given the number that are now offering four-year degrees that they believe get students to in-demand careers at lower cost. The ability to pivot quickly to market needs has created opportunity for other institutions, such as Antioch University, whose Seattle campus Baird will be heading. Antioch in Seattle and other campuses around the country sprung out of Antioch College in Ohio. The two are now independent of one another. The original Antioch had to shut down for several years because of declining enrollment and money woes, before reorganizing and reopening.

Nimbleness is not a trait associated with big educational institutions such as UW, but they know they must change. The experiment with MOOCs (UW already offers public online courses through Coursera) is not an end in itself; after all, there are costs associated, and as yet no revenue model. But as UW President Michael Young said in a news release, “As a large, public research institution with a mission to increase access to education, we’ll continue to explore the forefront of educational delivery, evaluate teaching and learning effectiveness, consider trends, and drive research to improve higher education.”

UW is experimenting to see if this approach works and if it can be melded into or even replace (UW’s Coursera offerings have a component for converting to for-credit, fee-based courses) some aspects of instruction at a traditional four-year school.

The experiments will continue unless the scientists in the UW’s labs perfect alchemy or dollar cloning. Money may not be the end goal in either sector, but money is what makes pursuit of good health or education possible, and as with just about every human endeavor, health care and higher ed are challenged as never before to collect more while spending less.