Investor and Warren Buffet partner Charlie Munger famously said, “Show me the incentive, and I’ll show you the outcome.” The quote serves as a rule of thumb when thinking about business and performance metrics, shorthand for how human behaviors can be profoundly altered by what at first glance may appear to be minor changes.
Recently, we’ve noticed a remarkable reduction in the number of sirens around town. While not a scientific number, you could usually count on ambulances hitting their sirens a few times a day. What changed? Beginning October 1st, Islanders started to become aware of a new care provider alternative. DispatchHealth parked their distinctive blue and white Ford Escape near the center of town and attended various community functions to promote their service and explain how it works.
The for-profit firm’s idea is to provide sophisticated mobile care, covering incipient, urgent, recurrent, and not-quite-emergency visits, staffed by nurse practitioners and emergency medical technicians, backed by trained physicians. Apart from the convenience of a house call, the biggest side-effect is cost savings for the patient. A DispatchHealth call comes to only a fraction of the typical ambulance and emergency room bill. Accepting most insurance plans, or a flat $375 fee, they “dispatch” directly to the patient’s address, where they diagnose, treat, dispense, prescribe, and re-direct or escalate as necessary. DispatchHealth is in network with Apple Health, with the exception of Molina, which they are working on.
At first, DispatchHealth had a few idle days with no calls. Then a trickle of requests started coming in. Positive word of mouth spread quickly, and over the course of only two months, their average call rate has shot up to about 5 a day.
This new alternative appears to have logically and perhaps permanently reduced former reliance on 911 services. DispatchHealth has also undertaken direct cooperation with the SeaMar clinic, providing both a scheduling overflow valve and effectively giving SeaMar’s community-focused services greater “reach.”
Perceptive readers will have noticed that other channels are exhorting local residents to call 911 early, often, and whenever in doubt. At best, appeals to increase 911 calls seem … awkward? DispatchHealth presents precisely the opposite incentive. Its mission is to NOT cross over into emergency care, but rather to head it off at the pass. DispatchExpress, its proprietary operations platform, is optimized to pre-route qualifying calls to local 911 EMS services, and its staff are trained to seamlessly transition patients for treatment or transport if and when warranted.
Bottom line, it appears the mobile health company’s service, so far unique but rapidly proliferating across the United States, including Tacoma, is being adopted here with open arms.
More bottom lines: VIFR’s property tax levy has increased by 30.4%, to the State’s legal maximum of $1.50 per $1,000 of assessed value. On top of that, VIFR received over $3 million in temporary Federal grants to fund additional staff and services, and has committed $4+ million for ongoing new construction.
This expansion is consistent with other trends. In the past few years, Washington State’s budget deficit has exploded to $12 billion, despite total tax revenues increasing at the same time by almost 40% ($25.7 billion in 2019 to $35.4 billion in 2023). Here on Vashon-Maury, we are now spending somewhere over $1,200 per Islander for fire and rescue services every year. Full disclosure, we are also spending $180 per Islander each year for the VHCD.
Actual emergencies will of course keep their place of honor. One of the most common 911 calls in the US is for suspected heart attacks: usually it’s just a scare, as distinguishing between severe acid reflux from a previous night’s indulgence and a life-threatening event can be almost impossible. In such cases, and for the real McCoy, we have the best paramedic service, Medic One, top-rated in the US for cardiac transport and outcomes. It has its own separate tax levy and is right here on the Island, always ready to go.
We have more mobile responders than before, with four different types: VIFR, Medic One, DispatchHealth, and Mobile Integrated Health. A few hiccups may be expected while procedures adjust behind the scenes. Getting the right response to patients will benefit from more information about options, plus transparency and teamwork between providers. We can continue to rely on 911, secure in the knowledge we’ve got upgraded capacity – the emergency medical services equivalent of Amazon Prime.
For sub-emergencies, DispatchHealth (253-617-4010 and https://www.dispatchhealth.com/locations/wa/vashon-maury-island/) and SeaMar (206-463-3671) have already started coordinating, each offering much appreciated on-Island daytime options. To the extent there have been some tensions between the VHCD’s DispatchHealth initiative and VIFR’s MIH, we note that VIFR’s Chief Vinci has recently announced his departure. We hope this change of leadership offers an opportunity for the organizations to find a more cooperative, or even thriving, relationship while serving Islanders’ health and emergency needs.
