Las Vegas Health System Sees Market Share Triple after Integration

by HCE Exchange on April 28, 2015

Rod-Davis-thumbThe Dignity Health system of hospitals has been making rapid gains in market share within the competitive Las Vegas Valley. Case in point, Dignity Health-St. Rose Dominican, located in Henderson, Nev., is the only not-for-profit, religiously affiliated health system in the area.

Since 2000, St. Rose has expanded from one hospital to three acute-care facilities, along with other entities, to become a fully integrated delivery system.

Rod A. Davis, senior vice president of operations for Dignity Health Nevada, has been with St. Rose for 22 years and has seen the system go from holding 5 percent of the market share in Clark County to 18 percent.

Building integrated systems and educational partnerships

With this expansive growth over the past decade, St. Rose has been focused on a clinical integration initiative, working with physicians to integrate data systems, negotiate payer contracts, and develop a delivery model focused on patient population management.

Davis said there are more than 600 physicians contributing to the initiative and working to capture patients before they are admitted to the hospital and manage them more efficiently while they are in the hospital. At discharge, the system facilitates transfers to sub-acute facilities or manages care in home to help prevent readmissions and improve quality of life.

“We have developed partnerships with physicians,” Davis said. “There is a lot of anxiety among physicians today with the transitions in healthcare. We want to establish positive relationships that support them. We think it’s the right thing to do to deliver better care at a lower cost with improved outcomes.”

The initiative is about a year old and has one managed care contract already. Davis expects over the next two years to have the systems and infrastructure in place to manage patients more effectively, generate value to physicians, and demonstrate performance to major employers and insurers.

St. Rose is also looking to fill a need in the area for training programs and has established an academic relationship with Stanford University Medical Center.

Las Vegas doesn’t have a major academic medical center, but with the relationship with Stanford, St. Rose has a linkage over several service areas, including neurosurgery, pediatric neurosurgery, cardiovascular and thoracic surgery, and transplant. St. Rose has four full-time Stanford faculty on site and in private practice. Additionally, a Stanford clinic is located adjacent to the Siena Campus.

Davis said the organization has been approached by a number of medical schools to offer a residency program, and future plans are being made to develop a number of residency training programs.

“Having graduate medical education here enhances our care delivery model for this community,” Davis said. “It will make a difference in the level of service we provide to residents of Las Vegas and Clark County.”

Getting positioned for a changing environment

Davis said St. Rose and Dignity Health Nevada are preparing for the transformation in the healthcare industry, regardless of changes made to the Affordable Care Act.

“A change is occurring in healthcare, and it has to,” Davis said. “The system we had before is unsustainable.”

St. Rose is looking at ways to reduce costs across all service areas and integrate the three campuses to act as one organization.

Davis said he is seeing economies of scale through the integration. A new patient-centered care nursing model has been implemented across all three campuses that combines case management with a charge nurse and bedside caregiver as one team working with the physician. This program has led to improved clinical outcomes, more efficient care, and higher patient and physician satisfaction.

Davis said the organization is also seeing a reduction in supply and medical-equipment costs through integrated purchasing systems.

To prepare for a changing environment, St. Rose is looking at models with employed physicians. Nevada has typically not had a history of hospital systems hiring physicians.

“We think it is important that we make an employment option available to physicians,” Davis said. Dignity Health Medical Group, a multispecialty physician practice, also strengthens the hospital’s strategy to work closely with physicians and maintain a strong presence in the community.

Davis feels confident that Dignity Health-St. Rose Dominican is well positioned for the future. The organization has developed a strong reputation within the community as a well-managed, trustworthy system.

“We have consistency with the workforce and medical staff over a long time, giving us a common focus, common objectives that we work together to achieve,” he said.

In an industry where many organizations feel pressure to cut expenses and staff to achieve success, Davis said St. Rose will “innovate ourselves to success, rather than cut ourselves to success. Our employees and physicians are engaged and encouraged to think outside the box to find better solutions. As an industry, we need to be flexible, willing to adapt and embrace change as we move forward.”

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