Carson Tahoe Health CEO: Industry must figure out how to reduce costs

CARSON CITY, Nev. — Six months into his tenure as CEO of Carson Tahoe Health, Alan Garrett says the hospital, like healthcare providers everywhere, is in a state of flux, facing huge challenges and trying to find its way in an industry he says is changing rapidly.

“There is continual pressure on reimbursement,” he said. “On a super-macro level, America spends roughly 18 percent of GDP (Gross Domestic Product) on healthcare, which is 10 times what the next 10 countries do,” he said.

He said all efforts in the industry are “geared toward reducing the cost of healthcare.”

“The industry as a whole, including Carson Tahoe, has to figure out how we deal with that.”

At the same time, in order to keep the doors open, he said that even though CTH is a nonprofit, “we have to have some financial return at the end of the day.”

He said there isn't one answer, that everyone in the industry has different challenges.

“It's understanding the needs of your community,” he said.

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In Northern Nevada, Garrett said that need has a lot to do with access — more specifically, the lack of access.

“When you think of Northern Nevada, there's a lot of square miles to cover,” Garrett said. “We don't have physicians and other clinicians to meet the demands of the population.”

He said one young mother told him when her child gets sick, the only time she can really take off to get him to a doctor is in the evenings or on weekends when, he conceded, most healthcare facilities and doctor's offices are closed.

Garrett called for “more of a grassroots community focus,” saying the answer is to take CTH's services out into the community

He said traditionally, people think of first responders responding to a crisis.

“It makes me wonder, are there ways we can be out in the community responding before a crisis?”

“It's not just about taking care of sick people,” he said. “We need to figure out how to keep people healthy. It's right now skewed toward taking care of sick people.”

Garrett said CTH is already reaching out with its services. In addition to the hospital, the cancer center and surgery center at the north end of town, the old hospital on Fleischmann is now a long-term care center.

And he said they are operating 21 sites scattered across Northern Nevada.

The list includes sites in the Tahoe Basin, in south Reno, Douglas and Lyon counties and as far south as Mammoth in California as well as in Carson City.

“That's really where the future of health care should be, getting the facilities out to the community,” he said.

Garrett said in the past, physicians and others in the industry wanted to build offices around the hospital.

“It was convenient for everybody in the medical world but may not be convenient for the community.”

“We need to get care more easily accessible, out in the community and in ways which people can actually get to it easily. It's about encouraging healthy lifestyles and early diagnosis and treatment.”

He said technology is key to that process.

But Garrett said the problem goes beyond just health care. The access problem, he said also involves how far people live from other facilities and services including such things as grocery stores.

“A lifestyle based on convenience foods isn't healthy.”

Garrett, 55, said CTH is also working to bring the best professionals into its system. He said Carson City was an easy fit for him because he's an avid backpacker and hiker, a skier and fisherman.

After six months at CTH, he said he likes the area and the hospital, which he described as an excellent facility. He said he also likes his staff because they treat their jobs as more of a calling than just a job.

Those are some of the attractions he says he's using to try to attract top-flight physicians and other health professionals to the area.

“There are only a certain percentage of new doctors who say I want to be in a place like this,” he said.

He said for doctors who want to practice in a large group situation, “this place is probably not going to work for you.”

“We're getting into the business of attracting doctors. We're one of the highest rated hospitals in Northern Nevada, it's a gorgeous environment, moderate climate. We've got the mountains to play in and don't have a bunch of traffic but have all the amenities you want.

“I think that's a really attractive proposition.”