Health care's fiscal fitness

Trends affecting the health care industry during 2008 will range from the popularity of fitness programs in the near term to robotic assists in the long term. Ongoing challenges include staffing shortages and outreach to Nevada's far flung rural counties.

But the challenge will come as ripples from softening national economy result in an increase in the uninsured.

The uninsured and the Medicaid populations continue to grow, says Bill Welch, president and chief executive officer of the Nevada Hospital Association. The challenge health care providers face: How to expand and improve availability in light of that.

"A single patient bed in a newly constructed hospital carries a price tag of $1 million," he adds. "In response, hospitals must constantly evaluate systems to become more efficient."

The popularity of wellness programs swelled membership at St. Mary's Center for Health and Fitness to 4,500, says Donald Kowitz, president and chief executive officer of St. Mary's Health Plans. In addition to membership among the community at large, the center helps hospital patients transition from physical therapy.

The incoming president at Saint Mary's Regional Medical Center determined rural needs by visiting rural hospitals. He discovered that patients needing specialty care not offered by the rural facilities had difficulty transferring to an urban center. In response, Mike Uboldi launched the hospital's Easy Admittance Program, a way to ease patient admissions to St. Mary's.

Nursing shortages continue to plague the health care industry, but more acute is the shortage of technicians to provide services such as physical therapy or radiology, says Kowitz.

Recruitment for Saint Mary's, however, is looking up since the hospital joined with Catholic Healthcare West, which now helps with recruitment.

"Californians want to come to Nevada," he observes. "This is a tremendous opportunity to pull people interested in relocating here."

Another bright spot on the far horizon: Saint Mary's is at an early stage of evaluating the potential for robotics in surgery. The technology provides increased accuracy for extremely precise surgery. And trauma can be lessened, because the incisions are smaller than those produced by the human hand. But robotics can also dramatically expand the reach of a human hand, even into the rural counties, allowing a surgeon in Reno to operate on a patient in Elko.

Meanwhile, in Carson City, Carson Tahoe Regional Healthcare continues to see population growth in its primary service area, particularly in the Dayton corridor, says Cheri Glockner, director of development and public relations. And late 2009 will see the Carson Tahoe Dayton Hospital open.

On the legal front, she notes state transparency regulations will be a focus in 2008. Carson Tahoe will participate on a state level to ensure compliance with the new transparency legislation passed in 2006.

The wild card, says Kowitz, is politics specifically, post election: What might newly elected policymakers do about national health care. "It may result in an attempt at societal shift in health care."

However, says Welch, it's not realistic to expect that will happen in the next Congress. Despite the results of a poll conducted by a consortium of hospitals, which tagged voters' number one issue: Health care reform.