(left to right): Jennifer Schomburg Market CEO, Las Vegas, Gerd Peters, and Joy Cleveland (left to right): Jennifer Schomburg Market CEO, Las Vegas, Gerd Peters, and Joy Cleveland

The Las Vegas healthcare market has shifted almost as quickly as the action on a casino table.

There are 13 hospitals and three healthcare systems there. The area has a population of roughly 2 million, with about 83 percent in managed care.

Two years ago, there were 420 individual on-staff doctors. But a year ago, internal medicine physicians consolidated into five “super groups.” Now most of the hospital systems in Las Vegas use contracts with hospitalist groups rather than employing physicians. Physicians generally direct referrals to those that cover post-acute settings, and patients are placed when and where the care is appropriate.

Four years ago, the patient mix shifted from 65 percent Medicaid patients to mostly patients covered by commercial plans and Medicare Advantage.

The lesson gleaned from those experiences was to become comfortable with change and ambiguity. That included creating a forum for dialogue, openly sharing issues and ideas, and streamlining decision-making within the division.

Then the division had to be willing to change. Capital investments were made to provide what payors requested. The division also formed a committee to move patients across the continuum.

Gerd Peters, District Director of Sales and Marketing, had advice for Kindred divisions working on their Transitions of Care: “Know your market and monitor the trends and the volume of trends by (service) sites. Prepare to ‘right-size’ your offerings” to what is needed and fill in any gaps in facilities.

There is still a gap in the continuum – the division needs an in-patient rehabilitation facility, “but we’re working on it,” said Jennifer Schomberg, Kindred Hospitals of Las Vegas Market CEO.

Joy Cleveland, Director of Managed Care Payor Relations in Las Vegas and Arizona, also participated in the session at the Clinical Impact Symposium.

(left to right): Jennifer Schomburg Market CEO, Las Vegas, Gerd Peters, and Joy Cleveland