Billings Gazette, December 20, 2015
During the summer of 2014, Montana Gov. Steve Bullock stood before a crowd of more than 200 business and health officials from Montana and Wyoming and told them just how big of a role health care plays in the state's economy.
"It's no secret that here in Montana the health care industry is, and will continue to be, a crucial part of our state's economy," he said, opening the Big Sky Business Health Summit in Billings.
Eighteen months later, that's especially true in the Billings area, home to the state's largest medical community, which includes two regional hospitals and a county health agency.
In 2014 Billings' health care industry employed an estimated 13,000 people — roughly 16 percent of the city's employment — and accounted for more than $1.2 billion in direct and indirect payroll, including $641 million in wages to health care workers, which represents about 20 percent of the total wages in town.
"Billings has continued to become a hub for acute-care medicine, sub-specialty care, so we continue to see that growth," said Jim Duncan, president of the Billings Clinic Foundation.
The majority of that radiates from a medical corridor at the north end of downtown that holds the sprawling main campuses of both St. Vincent Healthcare and Billings Clinic, two regional hospitals that offer a wide range of services and oversee facilities or clinics scattered across Billings and Montana.
"It's quite a footprint when you look at it," said Steve Loveless, St. Vincent CEO. "As we see more health care services and as we grow, it shows that it contributes greatly to the community."
Billings Clinic is the largest employer in Yellowstone County, with roughly 4,000 employees paying an estimated 9 percent of the residential property taxes in the county.
Expansions have been a major driving force for both hospitals, both on their home campuses and throughout the state. St. Vincent, for example, has sites in the Heights, Grand Avenue, Shiloh Road and Broadwater Avenue in Billings, in addition to facilities in Laurel, Red Lodge and Hardin. It also helps maintain and operate hospitals in Miles City and Butte through its parent organization, the Sisters of Charity of Leavenworth.
Its Billings facilities make up more than 863,000 square feet.
Conversely, Billings Clinic has off-site facilities in the Heights and West End, five ExpressCare clinics at four locations across Billings, a West End assisted-living facility and primary or specialty care clinics in Bozeman, Columbus, Miles City, Red Lodge and Cody; manages 11 critical access hospitals across Montana and recently took over management of Community Health in Missoula through a joint venture with Tennessee-based RegionalCare Hospital Partners.
"A lot of hospitals around the country have seen a downward trend in inpatient hospital volumes, but we haven't been seeing that here," Duncan said. "The volume here is still growing when it comes to hospital patients. That's why you've seen a lot of construction over the last few years. We're trying to keep pace."
The hospitals also make a point to hire local contractors and businesses if possible when it comes to construction.
While there are out-of-town sites, Billings' health care industry brings in plenty of out-of-towners on its own. More than 40 percent of the two hospitals' inpatient visitors come from outside of Yellowstone County, while about one in 10 come from out of state.
According to the Big Sky Economic Development Authority, that has led to an extra 3,700 health care jobs and as much as $218 million in wages, as well as the millions of dollars those visitors spend outside of the medical community while in Billings.
"That's a big deal," Loveless said.
There are also plans for future growth, which could plug millions of dollars into the community through construction and related services.
RiverStone Health, Yellowstone County's public health agency, announced in September that it is raising money to build a new $11 million, 25,000-square-foot primary care clinic near its current building off of South 27th Street.
Officials expect to break ground on the clinic sometime in the spring of 2016.
"We have squeezed every bit of space there is out of that old building," said John Felton, RiverStone president and CEO, at the project's announcement in September. "In terms of pure space, we just need more."
While specific details weren't immediately available, St. Vincent officials said that they also have plans for expansions, including off of the main campus downtown, that would include construction of new buildings.
"We're continuing to grow and our service lines are a huge focus for us," Loveless said. "That's a major part of our plan, with a slow migration of largely outpatient services on the West End."
At Billings Clinic, specific plans weren't available, but Duncan said that the hospital will continue to grow and adjust to meet the needs of the community and the region.
"Billings is in a very good spot right now as a community, with positive outlooks for growth and continuing to become more of a regional center related to health care," he said. "The growth needed for the health care workforce education and development is significant, and we are going to continue to play an increased role in that."
Local health care officials are also keeping a close eye on the effect of Montana's recent Medicaid expansion, which takes effect on Jan. 1.
According to the Montana Budget and Policy Center, there are 7,215 uninsured adults in Yellowstone County eligible for the expansion, which could result in an additional $44.5 million in Medicaid spending, an anticipated job increase of 1,370 and and possible annual labor increase of $57 million.
"As newly insured Montanans seek health care, there will be an increase in the demand for doctors, nurses and other medical support staff," the center said in a report issued in January. "Health care providers can hire new employees who will then spend their paychecks in local businesses ... What starts as a small investment in Medicaid expansion actually triggers a chain reaction of economic development."
As Bullock said in 2014, the health care industry is likely to play a crucial role in the Montana economy. According to a Montana Department of Labor and Industry report published in 2013 projects Montana's health care industry to grow by about 1,300 jobs each year through 2022, spurred in large part by an aging population that is expected to see more than 30 percent of Montana's population older than 60 by 2030.
And with Billings offering more services from the state's largest providers, many of those jobs could end up in Billings.
MBPC is a nonprofit organization focused on providing credible and timely research and analysis on budget, tax, and economic issues that impact low- and moderate-income Montana families.