, Nevada's Only Statewide Business Magazine Any business, no matter how large or small, has We offer loans for: times when it needs rmancing for capital improve­ ments, real estate acquisitions, new equipment, or • Owner Occupied Real Estate a variety of other needs. with up to 25-year terms Bank of America, the #1 Preferred Lender in the state, specializes in long-term business rmancing. No prepayment penalties Bank of America is able to process your loan requests No calls to meet quickly and efficiently. We tailor loan terms to your • Machinery and Equipment* business needs and cash flow. Save 50% on appraisal fee. For a limited time, • Tenant Improvements* we are offering 50% off the appraisal fee, up to $1,500. • Business Acquisitions* PLUS we'll waive the processing fee up to $750. There's never been a better time to apply. Stop by any Bank of America branch today or call SBA Lending Services in Las Vegas at (702) 654-6871 or BANKING ON AMERICA® in Reno at (702) 688-8509. m Bank of America

'Fully amortized. Terms up to 10 years at competitive rates. Offer expires September 30, 1994. ©1 994 Bank of America Nevada. Member FDIC. ~ ~BUSINESS J~romthe ~tor by Connie Brennan ONE of the problems with healthcare form. Maybe I've yet to meet the right ~OURNAL reform is just when you think you have a people, or perhaps, the issues are under­ marginal understanding of what's going going such rapid change, there are no on ... the plan changes. real experts on the subject. With a number of competing political Although we have not ignored health­ proposals currently under consideration care reform in this issue of Nevada Busi­ in Washington (at press time there are ness Journal, we chose to focus more on nine "packages" of legislation circulat­ the progress of companies involved in ing on the Hill), it is almost impossible the delivery of healthcare in our state. to stay abreast of the latest issues con­ While the movers and shakers in cerning healthcare reform. Nevada's healthcare industry are braced It appears that, with elections coming for change, they continue to move for­ PUB USHER up in November, Congress is under pres­ ward with ambitious plans for the future. Lyle E. Brennan sure to pass something now. And we all And, even though, the business of pro­ share the concern that, instead of passing viding healthcare has never been more ASSOCIATE PUBLISHER- EDITOR uncertain, those leading Nevada's larg­ Connie Brennan healthcare reform legislation based on a bipartisan understanding of the problems, est healthcare companies continue to dis­ ASSOCIATE PUBLISHER - SALES play a confidence in their ability to adapt Earl Johnson Congress will act without complete knowledge on the real issues facing our to whatever changes come their way. ASSOCIATE PUBLISHER - NORTIIERN NEVADA There is clearly a revolution of health­ Eklof & Associates current healthcare delivery system. Even though we're all talking about it, care delivery going on in our state. But it ASSOCIATE EDITOR- ART DIRECTOR I've yet to meet anyone who considers seems to be "in spite of' and not "be­ Barbara L. Moore themselves an expert on healthcare re- cause of' th~e nation's healthcare reform. SENIOR ACCOUNT EXECUTIVE Chuck Dandy CIRCUlATION/DISTRIBUTION Margaret Cooper CONTRIBUTING EDITORS Building an Integrated Continuum Jerry Ash I Kathleen Foley I David Hofstede of Care for 47 Years. George Knapp I G.W. Kring Kelly LeGrow I David Moskowitz Kelly Sullivan I R. Keith Schwer t. Rose Dominican Hospital is NORTHERN NEVADA SALES REPRESENTATIVE Eklof & Associates Spositioned on the forefront of 589 California Ave • Reno, NV 89509 medical technology. Our state-of­ (702) 323-8013 the-art facility equips physicians The Nevada Business Journal is listed in Standard with the latest medical and Rates & Data, #20A-Business-Metro, State & Regional. Advertisers should contact Chuck Dandy at (702) diagnostic resources available. 735-7003 in southern Nevada, or Eklof & Associates at (702) 323-8013 in northern Nevada, or write to: The Nevada Business Journal, 2127 Paradise Rd. , Las Vegas, NV 89104. Demographic information available l hospitals offer services, but upon request. Month-to-month circulation may vary. A St. Rose Dominican The Nevada Business Journal corporate offices are located at 2127 Paradise Rd ., Las Vegas, Nevada 89104. enhances those services by NBJ is published bi-monthly, bulk postage paid. Sub­ scription rate is $27.00 per year. Newsstand price is providing an atmosphere of $5.00 and special order single copy price $7.00. All contents 1994 copyright, and reproduction of compassion and caring which material appearing in NBJ is prohibited unless so au­ remains unsurpassed by any thorized by the publisher of NBJ. CHANGE OF ADDRESS: Please send previous ad­ health care organization in dress or mailing label & new address. Allow six weeks. EDITORIAL SUBMISSIONS: Address all submis­ Southern Nevada. For more sions to the attention of Connie Brennan. Unsolicited manuscripts must be accompanied by a self-addressed information, please call stamped envelope. NBJ assumes no responsibility for 564-4507. unsolicited materials. DISCLAIMER: Editorial views expressed In this magazine are not necessarily those of the publisher. -Q-st. Rose Dominican Hospital T 102 E. Lake Mead Drive • Henderson, NV 890 15 ' "I'd feel a little pain now and then, but I didn't think it was anything serious. Maybe ~ecause I didn't want to ... "But I finally went to see my doctor anyway. And it was a good thing I did, because it was serious. It was my heart. "I needed a cardiovascular specialist and surgery. That meant the hospital. "I was worried, sure. But only about me. Not about what it took to get me well. All along I knew I was being cared for-and cared about -by lots of people, start to finish. Lots of people I never even met. "And I got well. Thanks, HPN. It may not have been easy, but you sure made it simple." ~ HEALTH PLAN OF NEVADA, INC. SM A member of Sierra Health Services, Inc.

Please refer to the Certificate of Coverage for limitation and exclusions. S29 july/August 1994 IC 0 NTENT S Volume 9 -No. 4 Features D HEALTHCARE As costs spiral, managed care organizations,featuring efficient networks of providers and hospital facilities, emerge as the industry vanguard. m Good Health - Lifestyle is the key An informal survey of local health clubs and natural food stores produced a variety of recommendations on keeping healthy and fit. IC FHP Health Care offers care at home In today' s evolving healthcare environment, FHP Health Care sees a resurgence of treatment within the home. m Nevada MCOs and PPOs - Where is the money going? Make sure the PPO and utilization management company your healthcare plan uses is On the Cover: Sunrise Hospital working in your company's , and your employee's, best interests. Medical Center and Sunrise Children's IEI:J UMC: Providing state-of-the-art care to southern Nevadans Hospital is the Keeping pace with technology and the rapid growth of the community are the goals largest hospital of University Medical Center. complex in the state. Page 24. EEJ NNMC: Meeting the needs of Sparks and the Truckee Meadows With a name change and numerous new programs on line, Northern Nevada Medical Center is poised to provide cutting edge medical care to area residents. m Sunrise Hospital: Putting reform into action After implementing reforms and improvements at his own facility, Sunrise Hospital President/CEO Allan Stipe takes aim at the White House plan.

Eil CAMPAIGN '94 Election year 1994 is unlike any in recent memory. Here's a "snapshot" of the significant statewide races taking place this year.

Departments EI] Executive Profile EIJ Healthcare Briefs Dr. R.D. Prabhu devotes time to Increasing efficiency the key to reform at medicine and Asian American causes. Health Care, Inc. • Horizon Compcare awarded SIIS contract • Sierra Health m Speaking for Nevada Services declares second quarter profit. Jerry Ash reveals the truth about hospital costs. m Hospital Happenings Valley Hospital wins award • St. Rose m TaxTips Dominican announces board members • National healthcare .. . at what price? Jerry Ash, president and Rehabilitation Hospital marks anniversary • CEO of the Nevada Lake Mead Hospital continues growth. Hospital Association, EEJ Business Indicators & Analysis discusses hospital costs. With the Fed pushing up interest rates, ED George Knapp Page 29. attention is focused on inflation. Adventures in Business Travel We have BIG plans for small businesses too.

Who says companies have to employ hundreds of people to offer comprehensive, affordable healthcare?

Sure, we provide coverage to big companies, but at Sierra Health & Life Insurance Company, we also specialize in designing plans for smaller companies.

Our comprehensive, wide range of plans are backed by Sierra Health Services, a leader in healthcare products that's been around for years .. .and will be ... for years to come.

For more information call your broker or a Sierra Health & Life representative. • Southern evada 702-871-0999 • orthern evada 1-800-477-4542 • Arizona 1-800-456-1199 • Colorado 1-800-873-0004 • ew Mexico 1-800-873-0004 • California 1-800-545-6441 • Utah801-263-2323

A member of Sierra Health Services, Inc.

Please refer to the Certificate of Coverage for limitations and exclusions. PD0538 Growth. The word FacilitY expansions is joined at Nevada's hip: ubiquitous Population growth. Business growth. Examples of growth within Job growth. Nevada's healthcare community Housing growth. are plentiful. Consider: School growth. • Lake Mead Hospital in Growth in gaming revenue. North Las Vegas: renovated its Growth in tax revenue. facilities and opened a $7.2 mil­ Growth ... growth ... growth. lion state-of-the-af!. three-story But one area of Nevada's critical care unit. growth may have gone unno­ • St. Rose Dominican Hospi- ' ticed: The health care industry. tal in Henderson: Southern It is the Silver State's mush- Nevada's only Catholic, not-for­ rooming population, health care As healthcare costs spiral, managed profit, non-tax supported hospi­ administrators say, that is fuel­ tal, recently announced plans to ing the expansion. build three ambulatory medical Nevada's population is cur­ care organizations, featuring efficient care centers, or satellite facilities rently estimated at 1.3 million. in southeast Las Vegas. Las Vegas alone beckons 3,000 The first center is located at to 5,000 new residents every networks of providers and hospital facili- Pecos and Wigwam. The new month, according to Las Vegas 16,000-square-foot facility is Convention Authority figures. ties, emerge as the industry vanguard. scheduled to open in November. In addition, Nevada attracts Ground breaking plans are un­ large contingents of seniors der way on the 20,000-square­ BY DAVID K. MosKoWITZ seeking the state's low-cost, foot Hartwell Medical Center, at high-quality lifestyle. Add to Warm Springs and Shadow that the imminent graying of Crest. An additional 17,000- the Baby Boom generation, and the stage insurance providers are taking a pro­ square-feet is planned for phase two of is set for a potential overload of the cur­ active approach to meet future needs. the project. rent healthcare structure. Emphasis within the health care indus­ The third facility will be a joint ven­ "It is an important factor that the try as a whole, according to many health ture with physicians, and include a vari­ American population is getting older and care professionals, is shifting away from ety of outpatient services, such as urgent living longer. It brings forward the need lengthy and costly hospital stays, and care, an imaging center, rehabilitation, for a whole myriad of healthcare options instead focusing on cost-containing mea­ physical occupational and speech therapy, and services," said Patricia Brown, a Las ·sures such as outpatient services. and a laboratory. Vegas-based attorney who specializes in Managed care organizations, such as • Northern Nevada Medical Center health and tax-related issues. health maintenance organizations (formerly Sparks Family Hospital) in The pressures created by the increas­ (HMOs) and preferred provider organi­ Washoe County: Construction begins in ing demand for quality, cost-effective care zations (PPOs), are more attractive, not October on a geropsychiatric unit special­ has wrought an environment conducive only for smaller out-of-pocket expenses, izing in the care of people over age 65. to growth and expansion. Subsequently, but because of the efficient networking The unit will be attached to a wing of the many of the Silver State's hospitals and of healthcare providers and services. nursing area.

july/August 1994 - Nevada Business journal 7 Focus on Health

• Sunrise Hospital: In March, con­ Hospitals adapt to "It's a foregone conclusion there will struction commenced on a $25 million market shifts be another hospital in the area," he said. expansion and renovation project of the "However," he continued, "in spite of hospital's operating room area. "It was once common to have patients the apparent need, there is a troublesome Five suites will be added to an exist­ well enough to walk around a hospital and problem. As we convert the system to ing 19 rooms, all of which will be up­ yet not be discharged,"' recounts Jerry managed care, some people believe there graded with new technology. Moreover, Ash, president/CEO of the northern Ne­ will be an even greater reduction in the southern Nevada's first bone marrow vada-based Nevada Hospital Association. utilization of hospitals, and thus less need transplant unit will soon be in operation "Nowadays, if people are healthy to build new hospital facilities." at the facility. enough to walk around, they don't belong Hospitals are the most expensive way Early this year, Sunrise also opened a in the hospital," Ash said. "More people to provide care, he said. But with the $8.2 million, state-of-the-art central plant now recuperate at home to stave off sky­ managed care system, the selling point to which houses a 300-foot long service tun­ high hospital bills." the patient is the cost savings. nel, a bulk supply of medical gases and This trend in health care, said Ash - As a result, managed care services- in several energy efficient motors. termed outpa~ient care, where the patient the long run - could greatly reduce the • Resort Medical Centers (formerly enters for treatment and leaves that same need for hospital services. At present, Doctors On Call): A 24-hour full-service day- is now the emphasis, and has gen­ managed care only consists of25 percent · medical facility housed in the Imperial erally reduced the need for hospital beds. of the he; lth care market, Ash said. • Palace hotel/casino and catering strictly Ash said declines in hospital stays Allan Stipe, president and CEO of to tourists who fall ill, the center opened might normally bring a fmancial instabil­ Sunrise Hospital and Medical Center a second facility on the Strip late in June. ity, but Nevada's "phenomenal" popula­ and Sunrise Children's Hospital - the • Sierra Health Services (SHS) , tion explosion has offset such a trend. largest comprehensive medical facility in Nevada's largest insurance provider: In The rest of the nation is quite contrary Nevada - is already implementing a January, SHS moved into a sleek $22 mil­ to Nevada. "Across the country it's not strategy to employ the integrated man­ lion, 175,000-square-foot headquarters uncommon for hospitals to have half of aged care system. facility in northwest Las Vegas. their beds unoccupied," said Ash. "In this Stipe said the managed care delivery Last November, construction began on state, we've not experienced that low a system includes components such as the second phase of the 25-acre campus: number of unoccupied beds because of home health care, skilled nursing care, contemporary 45,000-square-foot medi­ the growth." psychiatric services, outpatient surgery, cal office building. Hospital occupancy in Nevada runs 65 and freestanding imaging centers. The master plan for the property in­ percent, according to Ash. "The objective of developing these cludes four more administrative office "I would hasten to add that 85 percent alternatives is to move the patient to the buildings and another parking structure. occupancy would be considered full," most appropriate level of care and to • Southwest Medical Associates, said Ash. "I know that doesn't make any reduce the cost," said Stipe. (SMA): SHS's oldest subsidiary inaugu­ sense, but in a hospital, bed space is spe­ "The major impact that we have seen rated construction on a satellite office in cialized. A hospital can be 85 percent full is that we are held accountable for our the Summerlin area. and still turn away patients because the costs in a competitive environment." Its Green Valley facility recently proper beds for their individual needs are The competition for patients, Stipe expanded to double its size and work is not available." said, heats up when hospitals bid for the underway for a new outpatient surgery "In order for a hospital to survive," said right to serve patients from targe managed center located near SMA's main campus Ash whose organization represents 27 of care organizations, which in turn bid to at Rancho and Charleston. 30 Nevada hospitals, "it has to be pre­ handle large self-insured businesses and • FHP Health Care: FHP is preparing pared to grow with the community." hotel properties. to open its first medical center with eight An example in Las Vegas, Ash said, is "The marketplace has become more primary care physicians on Rainbow on the rapidly growing west side. Of all competitive, and that has been keeping us Boulevard in mid-October. of the hospitals in Las Vegas, only two more competitive," Stipe said. Both SHS and FHP are moving to serve are located on the west side - Univer­ "Market forces have accelerated, spur­ the Reno area via HMO networks. sity Medical Center and Valley Hospital. ring private business and government to

8 Nevada Business Journal • July/August 1994 Better Health be much more aggressive," said Lake Care Starts Mead Hospital CEO, Ernie Libman. "I think they are aware they are in a strong position to play one hospital against another," Libman said, whose With ''u:~ hospital recently merged with Summit and OrNda HealthCorp., a Nashville­ based company. "To a large degree it's Commitment to the community is our number one priority supply and demand. here at University Medical Center, where the wide range of "We can maximize our profits only on services you require go hand in hand with the personalized the basis of volume, and therefore we have to be involved in most health plans customer care you trust. Because at UMC, we 're meeting that are largely determining what the rate the need for quality health care one person at a time. structure has to be," Libman said. For instance, Culinary Union Local226 consists of some 200,000 members and dependents, said Libman. As a conse­ llMC"Serving Southe rn Nevada Proud" quence, the union has significant purchas­ ing power - and influence - when it comes to health care for members. One example demonstrating the com­ petitive posture of hospital facilities can be seen at Northern Nevada Medical Cen­ Make ter (formerly Sparks Family Hospital). "We want to position ourselves to be known as the high-quality, low-cost, HORIZON hospital in order to pursue, and win, man­ aged care contracts," said Managing Director Mike Callahan. The hospital Compcare recently won a contract with Sierra Health Services to provide HMO hospital ser­ vices for seniors. Managed care is I~Your First Choice! here to stay Experts in Workman's Compensation • Over 900 participating physicians • Board certified industrial medicine "''Xvv T predict that by the end of this e physician director century, all healthcare services will be • Registered nurses available conducted within a managed framework," 24-hours-a-day, 7-days-a-week • Focus on prompt return to work, Ash said. "We are in the middle of a dra­ • Physician case management safety and cost control matic transition." He said the health care 24-hours-a-day, 7-days-a-week industry has changed from an old bou­ tique system where someone chooses .I Make your 1st choice Horizon CompCare! their own physician, to a managed sys­ 6122 W. Sahara Ave., Las Vegas, NV 89102 tem of care where there is a gatekeeper­ a primary physician who refers the patient {702) 365-1668 • FAX: (702) 365-6063 to a specialist when deemed necessary. "The industry forecast reveals that, in Work,ing for You!

July/August 1994 • Nevada Business Journal 9 the future, a freestanding hospital is a hos­ pital out of business," Ash commented. Hospitals need to fit themselves into networks, or vertically integrated health care systems in order to survive, he said. For example, hospitals are now seek­ ing to forge partnerships with managed care systems and physicians to provide a comprehensive full service health care product. "I can't think of a hospital in Nevada that is not looking for ways to form these networks," said Ash. "It's a matter of pooling resources. "The times are frightening," Ash con­ tinued. "Nevertheless, we support this change in the delivery of health care be­ Maybe you should too. cause we don't believe the current sys­ tem can sustain itself." As proof, he cites that one in four Nevadans are presently uninsured, and 50 percent of their health: care costs are subsidized by the govern­ ment through programs such as Medicare and Medicaid. Until a few years ago, the health care For more than 33 years, So, if you're looking system was operating on a blank check, FHP' has offered a for health care that Ash said. Taxpayers, employers, employ­ variety of health plans really works, get to ees and the government would spend that meet the unique know FHP. An idea whatever amount was needed. "Things changed. We've been on a cost needs of our members. Your health partner. For life.w whose time has come. containment track ever since," said Ash. To remain competitive, health insur­ FHP, Inc. Nevada Financial Center ance companies work to offer a greater 2300 West Sahara Avenue variety of health care products, with an Box 14, Suite 700 Las Vegas, Nevada 89102 -4354 emphasis on preventative care. (702) 871 -4441 "In spite of the fierce debate taking place over healthcare reform, the health care delivery system is undergoing a revolution," said Patricia Brown. LEARN PRACTICAL SELF DEFENSE The entire healthcare industry is shift­ ing from a curative method of medicine \VE HAVE A PROGRMf TAILORED JUST FOR YOU! to a preventative care emphasis, said Take our Executive Course and learn how to handle Brown, which may permit citizens to 26 potentially dangerous situations remain healthy longer. This is the case with FHP, Inc., one of Confidence Development • Stress Relief • Healing Therapy the states' largest insurance providers. Individually Tailored Programs • Private Lessons "We focus on quality health care by MEN•WOMEN•CHILDREN providing members with preventative care and focusing on low cost," said pub­ A Academy of Kenpo Karate lic affairs manager, Kayla Callas. 3025 E. Dese1·t Inn Rd. • Ste 7 • Las Vegas, NV 89121 • 733-7788 As to the reasons why managed care

10 Nevada Business Journal • July/August 1994 ANNOUNCING OUR NEWEST ICC/CCU services are becoming more widely uti­ 22·Bed Intensive Care lized, Callas said a quality product that Equipped with Latest offers members a wide range of provider Critical Care Medical choices is the key to a successful man­ Technology PULSE HEALTH SERVICES aged care operation. Home Health Care Agency For instance, at FHP, patients can WOMEN'S PLAZA choose from a list of FHP network pri­ Labor/Delivery Suites mary care physicians through two HMO 2Q.Bed Obstetrical Wing membership groups: traditional em­ ployer-paid members, or senior citizens - who are served by Medicare. FHP, with 1.6 million members nation­ wide, entered the Las Vegas market in 1992 and already touts a membership of 32,000 in the southern Nevada area. Health Plan of Nevada, Sierra Health Services' HMO product, serves approxi­ mately 120,000 members in southern Nevada. "Our success is primarily due to A HEALTHY CHOICE FOR YOU our company-wide emphasis on provid­ 1409 E. Lake Mead Blvd • North Las Vegas, Nevada 89115 ing quality care at reasonable prices," stated Sally Starr, vice president of cor­ porate affairs for Sierra Health Services. "Locally owned and operated, SHS rec­ ognizes and meets the healthcare needs WE ARE THERE WHEN YOU of its members. An important factor in our growth is the willingness to adapt to the NEED Us marketplace and offer a diverse product portfolio." As an example, Starr points to the company's newest product, Sierra Choice, which allows members to access care outside the HMO provider network. Both FHP and Sierra Health report tremendous growth in membership. According to Norm Becker, regional vice president for Blue Cross, Blue Shield of Nevada, consumer demand is driving down prices for various programs. As a EMPLOYEE MEDICAL BENEFITS result, insurance companies have to build in a price compatible with what people AND MANAGED CARE SERVICES are willing to pay. Because of these consumer-driven market forces, managed care insurance FOR GROUPS OF ALL SIZES products, such as HMOs and PPOs have become more affordable and therefore Contact: Dale Fratianne, Sales Manager more popular, Becker said. Marcia Hawkins, Director of Managed Care So strong are his convictions, Becker makes a prediction: ''Five years from now, 877-4444 J0 1'-800-887-6762 I believe the majority of people will be members of a managed care program:' •

July/August 1994 • Nevada Business Journal 11 Focus on Health

Good Health - Lilestvle is the l(ey

Suzanne Wallace, manager of Rainbow's End Natural Foods, offers a one-word sugges­ tion for better health: "Relax. Change your mental attitude. Allow yourself to slow down and enjoy life. If you must be in a stressful situation, don't internalize the stress and let it take control." As for diet and exercise, moderation is the key word, with emphasis on developing pro­ grams that are appealing enough to the indi­ vidual to motivate long-term participation. For good n ~ tural sources of vitamins and ~ fiber, fresh fruits and vegetables, preferably organically grown, received high marks as essential parts of a healthy person's diet. Nu­ tritionists also recommended whole grains and lots of water. And for those who prefer to con­ sume meats, hormone-free meats provide a more healthful alternative. "Pay attention to the ingredients in the foods BY KATHLEEN Nevada Business Journal's informal survey you eat," warns Charlotte Gardner, manager FOLEY of health clubs and natural food stores in of the Country Discount Health Food Store. southern Nevada produced a variety of rec­ "Maybe each individual thing you eat has only ommendations on keeping healthy and fit. a small amount of harmful substances, but Although there were predictable differences eating them daily over a long period of time of opinion about whether diet or exercise can cause damage." was more important, respondents agreed on Foods to avoid, according to those inter­ a number of key points. viewed, include any processed foods , espe­ According to William Andrade, M.D. , of the cially those high in refmed sugar, salt, chemi­ Medical Wellness Center at the Green Valley cals and hydrogenated fats. Soft drinks, Athletic Club: "The biggest challenge the av­ especially diet sodas, ranked high on the list erage person faces is how to develop and of sources of unhealthy chemicals. Although maintain a wellness program that becomes an most natural-food proponents discouraged effortless part of their regular lifestyle, and is consumption of "fast foods", others pointed faithfully practiced for years." to healthful choices like salads and baked po­ There are no miracle exercises, quick fixes tatoes which are readily available at fast food or magic diets. Instead, advisors encourage an outlets. Not surprisingly, alcohol and tobacco adjusted lifestyle which embraces healthy hab­ were also categorized as substances to avoid. its, both in exercise and diet. Although the majority of Americans are Positive mental attitude was mentioned probably familiar with these diet recommen­ often as key to overall health, with stress play­ dations, actually changing eating habits can ing the role of mental "saturated fat", causing prove to be a difficult task. As Steve Cline­ physical, as well as emotional misery. felter, district manager for Family Fitness Cen-

12 Nevada Buslness Journal • July/August 1994 ters, points out, "Most people know petrochemicals, and may contain sugar, the support of fellow members. Variety which of their habits are bad, but doing waxes, artificial colors and preservatives, should be a major factor in choosing a something about it is a problem." whereas those purchased in a health-food health club, according to Chad Smith, Eating a balanced diet can greatly re­ store are natural, easily metabolized and vice president of Las Vegas Athletic Club, duce the need for supplemental vitamins, contain no harmful substances. "When you join a health club, you can according to those surveyed. Most did not try many physical activities and fmd one recommend anything more exotic than a that works best for your physical needs good vitamin-mineral combination on a "E XERCISE is the best medicine," and also meshes with your personality. daily basis. However, anti-oxidants, es­ notes Barry Chaplik of Call It Class Fit­ Our job is to make the average person feel pecially vitamins C and E, did receive ness Equipment. Knowledgeable survey he or she fits in." Exercise experts advised favorable reviews. respondents advised exercising at least prospective club members to tour the fa­ On the subject of where to purchase vi­ three times a week, dividing exercise time cility before joining, talk with members tamins, there was a sharp division be­ equally between aerobic activity and and staff, and look for cleanliness, vari­ tween two camps. Some believed that a some sort of resistance weight training. ety and up-to-date equipment. store-brand supplement purchased at a Recommended time ranged from 20 min­ Those who feel that health club mem­ discount pharmacy would be just as utes to one hour per session. Some be­ bership is not the answer , ~may purchase effective as a similar pill from a health­ lieve health club membership is the an­ exercise equipment to use in the privacy food store. Natural food proponents, how­ swer to the average person's exercise of their own home. Of the respondents ' ever, commented the most commonly needs, offering a variety of equipment, who recommended purchase of exercise. used vitamin pills are actually based on classes, expert advice, socialization and equipment for home use, most favored a

Need a Fa:rnily Physieian? No-w is the tbne to call Nevada Medical Center Family Practice • Internal Medicine • Specialty Care Full Service Laboratory • X-Ray • EKG • Ultrasound Mammography • CAT Sean • Nuclear Medicine • Urology Caridae Evaluation • Cancer Screening • Physical Therapy DIRECT LINE CHARLENE McGLASSO N, R.P.T ...... 870-0814 WAYNE R. BUCHWALD, D.O ...... 459-7000 ERN ESTO A. M cCOM BS, D.O ...... 362-2775 STEVE N FALES, M .D ...... 877-5500 MITCHEL PH ILLIPS, D.O ...... 362-2775 JOH N HOLM ES, M.D...... 362-2775 PATRICIA PRINCE, M .D...... 384-9374 MICHA EL A. JONAK, M.D ...... 459-7000 BLAI N E PURCELL, M.D ...... 877-5500 DAVID LEONARDI, M .D ...... 384-9374 JOHN RHODES, M.D ...... 385-5972 J. JULIAN LOPEZ, M.D...... 877-1946 CHERYL B. ROBINSON, M.D ...... 362-1163 JERALD D. M ALONE, M.D ...... 459-7000 JAMES T. ROSS, D.P.M., R.P.T ...... 877-5932 J. KENT McBEATH, M.D ...... 362-1334 WILLIAM VON TOBEL, M.D ...... 384-9374 ROBERT B. McBEATH, M.D ...... 877-0814 THOMAS WONG, M.D...... 877-9500 FIVE LOCATIONS TO SERVE YOU BETTER 3880 S. JONES BLVD 5701 W. CHARLESTON BLVD 11100 700 SHADOW LANE 11160 601 S. RANCHO· C-19 4550 E. CHARLESTON BLVD Mon . Fri 7am to 6:30pm Mon · Fri Sam to Spm Mon · Fri 7a m to 3:30pm Mon · Fri Sam to 6pm Mon · Fri Bam to 6pm Sat Bam to 4pm Sat & Sun 9am to Spm Sat 9am to 2pm Closed Sun Sat 1D am to 2pm 362-1051 877-9500 385-5972 384-9374 459-7000 Nevada Medical Center "Your Partner in Health"

July/August 1994 • Nevada Business Journal 13 ~Strategic Options ..olll Strategic Planning ..olll Business Development ..olll Marketing

Our heatlh care specialty team can plan, Implement and Each individual should evaluate your next program or project. We offer the following services: take the time, and make

~ Strategic I Financial Plans the effort. to investigate ~ Operating Plans I Budget Development

~ Marketing Plans which foods, vitamins and

~ Business Plans I Feasibility Studies exercises work best. ~ Board Education I Retreats

~ Project Design I Management treadmill as a good way to get low-im­ ~ Service Development I Expansion pact exercise on a regular basis. Walking, ~ Due Dlllgence Analysis swimming and working out with hand ~ Customer Satisfaction Programs weights were also mentioned as good low-cost alternatives for those whose For more Information on how our services budget won't allow for club membership may benefit your business, contact: or purchase of equipment. -. Theresa Stempien, M.A., M.H.A. In summary, our experts agreed that , President each person should take the time and • 702-228-2213 make the effort to investigate which foods, vitamins and exercises work best. A personal survey might provide some insight to individual needs. It could in­ clude questions such as: Do you have any chronic health problems that need to be Rehabilitation addressed? What bad habits should you control and what good habits could you reinforce? Are you faced with stress on a Hospital daily basis? If so, how do you handle it? Do you prefer a fast-paced racquetball of Nevada-Las Vegas game or a leisurely walk? Are there cer­ tain vitamins or foods that make you feel "The Premier Free-Standing Physical Rehabilitation Hospital in Southern Nevada especially energized? Specializing in Comprehensive Inpatient & Outpatient Rehabilitative Services" Knowledgeable industry experts are readily available to answer general ques­ Brain Injury Pain Management tions about health and fitness. Many natu­ • Stroke • Orthopedic Disorders ral food stores have qualified nutrition­ • • ists on staff, fitness trainers may be found Neurological Disorders Spinal Cord Injury at your local health club, and bookstores • Arthritis • Back & Neck Program and libraries contain a wealth of informa­ • • tion on the subject. As always, it is ad­ Inpatient & Outpatient Ventilator Dependency visable to obtain the counsel of your • Services • physician before embarking on a new Work Hardening/ exercise and/or diet program. However, • Simulation each person must learn to become an ex­ pert on the subject of his or her own body. 1250 South Valley View Blvd., Las Vegas No one but yourself can answer your per­ sonal survey, and no one but yourself can (702) 877-8898 follow through and take the appropriate healthful action. •

14 Nevada Business journal • July/August 1994 ANOTHER WAY WE'RE LEADING THE WAY TO A HEALTHIER LIFE

"How I kept tny thutnb frotn costing tne an armand a leg.''

- Mike Stewart, consrrucrion worker

"I gee cuts and scrapes everyday of my Life on the job. Some only need a bandage, but ochers need a litde needle and thread. Fast-ER is perfect for me because it lets me get in and out and back to work in less time. And if you're like me, when you're off the job )'Ou're off the dock. That can cost you a lot more chan a little inconvenience, it can cost you real money." From minor injuries to minor illnesses, Valley H ospital Medical Center's Fast-ER is designed to keep the worry, the waiting, and the time between injury and treatment to a minimum. But that doesn't mean you get less care. While your problem may look routine it doesn't mean we treat it routinely. Whe ther you h ave a symptom or an injury, Fast-ER will give you the complete, thorough treatment you n eed for a fast recovery. Write for our free brochure. " ow there's a better way to treat minor emergencies. Fast-ER." Come to us next time you h ave a minor problem.

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FHP Health Care Oilers Care at Home

non-Medicare members is the same as the federally approved home care we provide to Medicare ben­ eficiaries through our Se­ nior Plan," said Fredrick. But, how does FHP de­ termine which of its mem­ bers would be better served within the home·? "Where a patient receives treatment-

J the hospital, a rehabilitation center or iri the home - is directed by their physi­ cian," said Fredrick. "And, the care each member re­ ceives within the home, whether it be personal aid, FHP's new medical IN TO DAY'S EVOLVING HEALTH CARE physical therapy or family counseling, is over­ environment, FHP Health Care sees one of seen by a registered nurse." center will include the most traditional types of medical care - Fredrick says that while home health care primary care treatment within the home - experiencing a can be less expensive, it may not be appro­ healthy resurgence. priate for some of its members. "The word physicians, "FHP's goal is to provide quality care in a 'home' can describe a wide variety of living quality setting," says Diane Fredrick, FHP's situations. FHP has a registered nurse assess dentistry, medical services manager. "More and more each home for the member's physician. If the optometry, select often, that quality setting proves to be the home is not a suitable setting for medical treat­ patient's own home." ment other arrangements for care are made," lab services, Frederick points out that treating patients at said Fredrick. "The key to quality health care home used to be much more common, and she is providing the most appropriate treatment in radiology and a believes there are numerous reasons for en­ the most appropriate environment." full-service couraging it now. "Recovery and rehabilita­ FHP Health Care is the second largest health tion, from illness or injury, can be much less maintenance organization in Nevada, and one pharmacy. expensive when administered in the home," of the largest health care providers in the U.S. said Fredrick. "In addition, people tend to re­ Through its health maintenance organization, cover faster when in nurturing surroundings." FHP provides prepaid medical and dental care Among home health care services FHP service to 1.7 million members in 11 states. provides are nursing care, personal aid, physi­ FHP is also the nation's largest Medicare risk cal and speech therapy, occupational therapy contractor, providing a comprehensive medi­ and counseling through social workers. There cal program that provides more benefits than are no additional charges or co-payments for Medicare - including vision care, outpatient these services. prescription drugs and no hospital deductibles "The home health care which we offer our -with no additional premiums. •

16 Nevada Business Journal - July/August 1994 One Phone Call. Two Pieces of Paper. Three-day Decision.

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Nevada MCOs and PPOs Who owns what, and where is the money going?

Make sure the REFORM OF HEALTH CARE and workers' like any other company. Let's take a look at a compensation has dominated headlines over physician-owned PPO and what might affect PPO and utilization the past year. A new version of health care the operation. The PPO collects a fee for pro­ management delivery known as managed care organizations viding a discount to the health plan at each (MCOs) have played an important role in the contracted provider. Typically, the physician company your debate. Many Nevadans aren't aware of the group that owns the PPO is centralized in the influences that various MCOs have on their provider network, positioned to receive a great healthcare health care and workers' compensation plans. deal of the patients. The physician group plan uses is MCOs in Nevada largely influence which performs the utilization review, that is, they· medical provider treats which patient. Direc­ determine if the procedure and/or the testing working in your tion of patients to medical providers for vol­ ordered by themselves and other physicians ume discounts was the initial intent of pre­ is "medically necessary" and reimbursable by · company's, and ferred provider organizations (PPOs). But is the health insurance plan. This position gives • your employees', that the case in today's marketplace? the treating physician carte blanche over what Medical providers can profit quite hand­ services to perform and what tests to order. best interests. somely by owning a PPO in Nevada. A PPO Furthermore, this power of approval gives can act as a marketing tool to actually direct the medical provider/PPO owner tremendous patients back to the owner/provider's clinic, influence over other participating physicians hospital or medical faci~ity . The PPO collects in the PPO. This also gives the PPO provider/ the service fee and then the owner/medical owner significant clout with the hospitals, who provider collects the medical claim dollar for are dependent on the provider/owner for ad­ treating a patient. In some cases, the provider missions and approval of patient stays. also acts as the utilization review component, Some hospital-owned PPOs face an alto­ determining whether or not the services the gether different set of problems. First, they provider gives are medically necessary. collect the service or access fee from the A recent October 1993 study by the Ameri­ insurance group. Typically, their hospital, or can Medical Association (AMA) revealed hospitals, act as the foundation of the hospi­ some interesting statistics. According to the tal network. Therefore, they also receive a study, "Treatment centers from rehabilitation great deal of the hospital claim dollar. They and physical therapy to other testing centers may be responsible for approving or denying owned by doctors have more than 50 percent the hospital stay as medically necessary - a more visits per year than similar facilities not delicate balance to maintain, since they are owned by doctors." receiving the claims dollar too. Or in the case of an insurance company This is where hospital-owned PPOs differ ownership, the utilization review may be per­ from their physician-owned counterparts. formed by the same company that adjudicates Hospitals cannot admit patients themselves. the claim. A very difficult position in which They are dependent on physicians to make to remain objective. admissions. Too many empty beds sets the So, you might.say, what's the difference? stage for insolvency. If the hospital-owned Aren't they all the same? Don't they provide PPO deems a service as not medically neces­ the same service, the same discount, the same sary, the admitting physician may choose to objectivity? Not always. utilize another hospital. Thus, the hospital puts BY G.W. KRING There are influences that affect PPOs just itself at risk of losing potential future revenue

18 Nevada Business journal • july/August 1994 from that particular physician. Of course ing director with William M. Mercer, Inc., this doesn't happen all of the time ... but Independent PPOs and a worldwide benefit consulting company it does happen. MCOs make more based in San Francisco. Another method Independent PPOs and MCOs make is to ask your health care plan consultant more sense in the managed care arena. sense in the managed for verification of where the medical The independent MCO collects a service care arena. They do claim dollars are being spent and com­ or access fee ... period. They do not typi­ pare the utilization management data of cally participate in the claim dollar flow, not typically participate your plan to local and state utilization therefore they are not at risk of losing in the claim dollar flow. averages. The key utilization manage­ lucrative revenue if they determine a ser­ ment areas to compare are: average length vice or test medically unnecessary. of hospital stay measured in patient-days­ Independent MCOs usually do not own selected providers. Independent MCOs per-thousand; and number of physician provider services. Therefore, they do not have no conflicts affecting objectivity. office visits. • pre-determine which clinic, hospital or What can you do to make sure that the other provider treats patients. They cre­ PPO and utilization management com­ ate an even playing field of providers and pany your health care plan uses is work­ G.W Kring is executive vice president let them compete for the patient through ing in your best interest? "The best thing for Managed Care Consultants. Kring is quality of service. In an independent to do is to actively support state and fed­ also immediate past president for the • MCO, patients choose the contracted eral legislation to discourage self refer­ southern Nevada Association of Health provider. They are not directed to pre- rals," said Dr. Arnold Milstein, manag- Insurance Underwriters. Take A Deep Breath ...

Breathing. lt's one of the The doctors at the Lung most basic functions of life. You Institute of Nevada are dedicated to don 't even think about it. That is making sure you can breath easy. until you have trouble breathing, They are experts in pulmonary shortness of breath or other symp­ medicine and have specialized train­ toms associated with lung ailments. ing you won't find anywhere else.

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July/August 1994 • Nevada Business Journal 19 Focus on Health

University Medical Center Providing state-of-the-art care to southern Nevadans

Keeping pace THE WIDE RANGE of services offered by spond 24 hours a day to the specialized medi­ University Medical Center (UMC) are evi­ cal/surgical needs of severely injured victims. with changing dence of its commitment to quality health care The UMC Trauma and Pediatric Center also medical to meet the needs of the community. houses UMC's new pediatric and pediatric For example: UMC was the first hospital intensive care units. Like the trauma center, technology, in Nevada to develop an organ transplantation they too are equipped with the latest in medi­ program; UMC is the state-designated trauma cal technology and staffed by specially trained the latest center for southern Nevada; the facility oper­ nurses and physicians. developments in ates the only bum care center in the state; and UMC's nursery includes a Level ill Neo­ UMC was the first in Nevada to have an emer­ natal Nursery, the highest level- of newborn patient care and gency department staffed 24 hours a day by care certified by the state. The nursery is . pediatric emergency physicians. staffed around-the clock by neonatologists - • the rapid growth Currently, the medical center has 560 beds, pediatricians who specialize in the care of of southern more than 800 physicians on its staff, and newborns- and specially trained nurses. employs hundreds of nurses, technicians, Sometimes sick or injured patients need Nevada are therapists and other highly trained personnel. care that goes beyond the treatment of their Because it is a clinical campus, the empha­ initial medical problems. This is the role of the objectives sis at UMC is not just on treating disease and UMC's rehabilitation team. at UMC. injury, but learning how fo provide better treat­ UMC operates the most comprehensive ment. This goal has been accomplished hospital-based rehabilitation program in through UMC's affiliation with the University southern Nevada. It cares for a variety of pa­ of Nevada School of Medicine. UMC and the tient needs from stroke to spinal cord injury medical school presently operate residency to traumatic brain injury. programs in internal medicine, gen­ UMC's rehabilitation team consists of eral surgery, obstetrics I gynecology and physicians and nurses, as well as occupational, general surgery_ A fellowship program physical and speech therapists. The team's to train pediatric emergency physicians was goal is to help patients realize their fullest recently added. potential and resume lives that are as indepen­ In response to southern Nevada's growing dent and productive as possible. population, UMC has established Quick Care Surgical services, including open heart pro­ Centers in many areas of the community. Each cedures, are available around the clock at center offers extended service hours, does not UMC, which features a modern radiology de­ require an appointment and provides an alter­ partment, outpatient surgery, coronary care native to the high costs and long waits asso­ and intensive care units, an orthopedic unit ciated with most emergency departments. and neurology unit. A major community asset operated by the Nevada's first organ transplantation hospital is its Level II Trauma Center. Located program was established at University Med­ on the first floor of UMC's new Trauma/Pe­ ical Center. The program's first kidney trans­ diatric Center, the trauma center is the most plant was performed on Christmas Day 1989, advanced facility of its kind in the nation. and in 1993, the team performed its first The trauma team's highly skilled medical pancreas transplant. professionals are prepared to immediately re- The hospital also houses Las Vegas' only

20 Nevada Business Journal • July/August 1994 Another UMC department

that greatly benefits the

community is its Lions

Burn Care Center. The

only burn care unit in

Nevada, Lions also serves

portions of Arizona, Utah

and California.

Comprehensive Cancer Center, where oncologists have developed one of Nevada's top cancer programs. UMC's Cancer Center nursing staff has received If You Don't intensive special education in oncology care and is certified by the National Control Them, Oncology Nursing Society. Aided by research shared among lead­ Who Will? ing cancer institutes, the UMC team can provide patients with the latest treatment Healthcare management helped advances. For example, it makes avail­ save more than a million dollars able to patients the latest developments HCI tor one of our clients. We'd like to in experimental cancer-fighting drugs, HEALTH CARE INCORPORATED show you how. Call today tor more including Interferon and Intraleuken. LAS VEGAS, NEVADA information (702) 876-2600. Another UMC department that greatly benefits the community is its Lions Burn Care Center, the only bum care unit in Pioneers in healthcare management Nevada. Not only does the unit serve the entire state, but also portions of Arizona, Utah and California. In response to southern Nevada's grow­ G ing and active senior population, Uni­ versity Medical Center has developed a Western Technologies Inc. community-based program. Called the The Quality People Silver Advantage Network, the program Since 1955 offers health education and screening, physician and healthcare referral, busi­ ENGINEERING , CONSULTING & TESTING OF ness and services discounts, Medicare ENVIRONMENTAL, GEOTECHNICAL & CONSTRUCTION MATERIALS claims assistance, interest-free hospital payments and medical savings. • TEL 702-798-8050 3611 W. TOMPKINS AVE . R.E. BRANNEN , P.E. FAX 702-798-7664 LAS VEGAS NV 89103 DIRECTOR

... Focus on Health

Northern Nevada Medical Center Meeting the needs of Sparks and the Truckee Meadows

With a name LAST JULY, Sparks Family Hospital an­ Organizations in September 1993. The 380 nounced its new name: Northern Nevada physicians on the medical staff of NNMC change and Medical Center (NNMC). The facility also represent over 30 specialties. The hospital's numerous new introduced several new programs, services and nursing staff provides family-centered total vital health resources now available to resi­ patient care. Decentralized management programs and dents of Sparks, the Truckee Meadows and the makes nursing and ancillary services more northern Nevada region. responsive. Staff members in all departments services on line, "In its 10 years of service, the hospital has are encouraged to participate in quality NNMC is poised worked hard to realize the vision for a healthy improvement activities. community," said Senator Randolph Town­ "The evolution of Sparks Family Hospital to provide send, keynote speaker for the NNMC rededi­ to Northern Nevada Medical Center is an ex­ cation ceremony. ample of the grewth, prosperity, and economic • cutting edge In late 1993, hospital senior manage­ significance of the Sparks community in medical care to ment, headed by Managing Director Michael northern Nevada," said Terry Reynolds, Callahan, developed a strategic plan to Sparks City Manager. the residents of develop the hospital's medical services. The NNMC is owned by Universal Health Ser­ goal: to meet the needs of the public and the vices, Inc. (UHS) one of the largest health­ Sparks and the demands of a growing managed care environ­ care management organizations in the nation. surrounding ment. After meeting with several groups UHS is also one of the largest hospital man­ within the Sparks community, a search began agement companies in the nation. The firm region. for a name to better reflect the comprehen­ currently operates 13 hospitals nationally, 13 sive nature of care provided by the hospital. psychiatric care centers and 13 ambulatory Among the new services to be implemented surgery centers. Among UHS ' other Nevada in the upcoming year are a skilled nursing fa­ holdings are Valley Hospital Medical Center cility, a new geriatric psychiatric program, an and the Goldring Surgical and Diagnostic on-campus dialysis center, a mobile MRI unit Center, both located in Las Vegas. and the area's first HMO for seniors. Based in King of Prussia, Penn., Univer­ "Our new name and programs," said Cal­ sal Health Services, Inc. (NYSE: UHS) was lahan, "represent a recommitment to meet the founded in 1978 and has expanded to 16 states growing challenges of managed care, man­ across the country. The 1993 August issue of aged competition and healthcare reform." US. News & World Report named UHS among Callahan has more than 15 years ' experience the top 25 most promising stocks. In 1993, in the healthcare field. Prior to joining Sparks UHS achieved record net revenues of $762 Family Hospital in 1993, he was director of million. This is the fifth year UHS has shown Amarillo Surgical Specialty Hospital. an increase. UHS was also rated in the May Northern Nevada Medical Center has served 23, 1994 issue of Modern Healthcare as one the Truckee Meadows area since January of the 10 largest for-profit health care systems 1983. The hospital is a seven-story general in the nation. Alan B. Miller, president and acute-care, community-based facility which is chairman of the board, attributes UHS's strong licensed for 150 beds. The hospital was performance to "investing in our people and awarded a three-year accreditation by the Joint our core hospital operations. Most importantly Commission on Accreditation of Healthcare we provide quality services at fair prices."•

22 Nevada Business Journal • July/August 1994 Is there an IMC near you? MCC provides LONE MOUNTAIN _L_ the largest •""- CRAIG ROAD L JtiL" m"- selection of ~ CH EYENNE AVE. ~ L ci '\ f% n ci ::; ::; CD CD 1'\'b SMOKE RANCH U) Industrial ~ // 3-- ~ - UJ m "\ L I LAKE MEAD BLVD. :s z Medical Centers " _L L_ m 0 m for Nevada ci > m ci co > co ~ I/ m>- co a: ;: s RING MTN. :;: injured workers. ~ t- ~ UJ ! ~ ' u. co Q_ UJ "' I- :::J z ~ni~(J U) CD 0 0 <( ~ UJ u z <( \I\ a: 0 FLAMINGO RD. UJ ~- :s>- INDUSTRIAL MEDICAL CENTERS a: <( m :::0 n - 1 Doctor's Clinic TR< PICANAAVE. \t\ 2 Doctors On Call ;:;: Family Doctors of Green Va lley ~ci::; U) 3 if R US ~LLRD . >r- U) 4 Family Medical Center I <( U) 6 Green Valley Family Urgent Care Center :s SUNSET RD. ~n li 7 Industrial Medical Group I ll ~ :----n m L, Industrial Medical Group II 71-.... 8 - " MAP NOT TO SCALE 9 Industrial Medical Group Ill :

Sunrise Hospital: Reform in action

that, while intended primarily as an outpatient facility, will also house clinical labs, diagnos­ tic imaging equipment and surgical theaters. These are just the latest developments in the ongoing betterment of health care in Nevada, which will hopefully lay to rest the persistent stigma that this is the last state in the Union where you'd want to get sick. "There have been considerable advances in Nevada," said Stipe. "We now have physicians with creden­ tials as good as any in the world. "Las Vegas, in addition to being an attrac­ tive place to live and work, has· reached that critical point in population growth where it is · able to support some of the more specialized • services," Stipe noted. "It takes a certain vol­ ume of work to keep a team of health care pro­ fessionals competent. You can't open a pedi­ atric open-heart unit and do 30 cases a year Sunrise Neonatal specialist Dr. John C. Kurlinski visits with proud new parents. and maintain the skills of your people," Stipe believes. "We are now doing 100 cases a year, After W RILE CONGRESS .DEBATES the health with outstanding results." Sunrise has also care bill of the week, Sunrise Hospital and opened a new bone marrow transplant unit and implementing Medical Center has decided not to wait for pediatric hematology/oncology facilities. reforms and word from Washington, D.C. on how to up­ As a founding member of the Healthcare grade service to its patients and the commu­ Coalition for Nevada, the hospital has become improvements at nity. Under the direction of President and CEO a leading advocate for health care reform - as his own facility, Allan Stipe, the hospital completed a top-to­ long as it's the type that will address the spe­ bottom retrofit, making considerable improve­ cific needs of Nevada. "We have a much Sunrise Hospital ments throughout the entire facility. higher than average percentage of uninsured President/CEO The most significant changes occurred in folks here," said Stipe. "We have the highest the operating theater. "The demands on our number of smokers, a high alcohol consump­ Allan Stipe takes surgical schedule are tremendous. We needed tion, and a large number of AIDS babies and aim at the White additional capacity," said Stipe. "Plus, our crack babies, all of which significantly drive operating rooms were over 20 years old, and the cost of health care higher." House plan. needed additional power for some of the The Healthcare Coalition of Nevada is com­ equipment now routine for a surgery suite." posed of the Chamber of Commerce, many Sunrise added 24 new operating rooms - a major gaming properties, labor organizations complete replacement of their present surgi­ and, yes, health care providers, whom Stipe cal facilities, which have since been adapted believes have been left out of the debate. "It into a larger labor and delivery department. has been a tactic of the Clinton administra­ Recently, Sunrise acquired a 30-acre site at tion to vilify healthcare deliverers as a spe­ Cheyenne and I-95, and announced plans to cial interest group that can't rationally con­ BY DAVID build the first hospital in Summerlin. The fi­ tribute to the process. I think that's a little silly. HOFSTEDE nal project will consist of a 250-bed hospital We do have some expertise because we live

24 Nevada Business Journal • July/August 1994 and work within the industry every day." Above all, Stipe believes the healthcare sional delegates. "Our approach is a logi­ After sifting through the various bills delivery system must be market-driven. cal one that addresses the vast majority being presented to Congress, the coalition "This is in clear opposition to the gov­ of Nevadan's health care problems. It's has composed a position statement of ernment coming in and telling us how not a panacea, but neither is the Clinton what it believes are the "essential" ele­ healthcare is to be administered. There is plan. Since the bill will have the size and ments in any reform agenda. Chief among no need for a national health board, scope of a new Social Security bill, it is their suggested reforms is the creation of regional alliances, global budgets, tar­ going to have a tremendous impact on us voluntary purchasing co-operatives. "This gets, triggers - they have a variety of in our everyday life." is particularly important in Nevada be­ names, but it's just the federal govern­ The alternative, says Stipe, is another cause of the huge number of small busi­ ment saying 'this is how much money we Catastrophic Medicare Bill, which Con­ nesses," Stipe explained. "A co-operative are spending on healthcare, and you're gress passed last year and later repealed would give them tremendous market not getting any more."' because of the uproar the bill created. power to bargain for great rates." To Stipe this sounds ominously like "Members of Congress were out of touch Stipe also supports tort reform to limit rationing. "Remember the days of gas with constituents. We need to guard malpractice and litigation costs. "I've got line? Price controls have never worked against a repeat of that performance .­ no problem being held accountable for as an effective means of containing costs. Whatever bill is passed, it must be an ef­ malpractice. However, some malpractice The only thing that's worked is competi­ fective tool to deal with the uninsured, claims are extraordinary." In this litigious tion. We all need to be held accountable and the cost of delivery of care. The gov­ environment, physicians are forced to for our costs in a competitive model." ernment must not be allowed to interfere practice what Stipe describes as costly The coalition is now trying to commu­ with those basic decisions you and I want "defensive medicine'.' nicate its position to Nevada's congres- to make with our own physician." •

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July/August 1994 • Nevada Business Journal 25 Campaign '94

ELECTION YEAR 1994 is unlike any in recent memory. Nearly every race statewide will be contested by two credible candidates and donors are having to stretch their already tight contribution budgets to cover each race. The following is a "snapshot" of the significant statewide races that will be on the ballot this year. by Kelly Sullivan

U.S. Senate- Incumbent Demo­ On the Republican side, Secretary of been on a ballot in years. With the vast , cratic Senator Richard Bryan has deep State Lau appears to have the early edge influx of new voters he won't be able to pockets and leads all candidates in in the polls. But her opponent, Persian rely on name recognition alone, and it fundraising this year. He faces no primary Gulf War veteran and former Assembly­ remains to be seen whether he can com­ opponent, but five candidates will duke man Jim Gibbons preaches a populist pete dollar-for-dollar with the "million­ it out on the Republican primary ticket. message with his petition that would al­ aire boys club" on the Republican side. Millionaire Charles Woods, who has been low voters to approve all tax increases. running television ads for the past three Attorney General- Early on months, is expected to vie with Hal Lt. Governor- The Republicans it looked as though incumbent Attorney Furman for the top spot and an invitation hold all the cards in this campaign as four General Frankie Sue Del Papa might be to face Bryan. millionaires have stepped up to vie for extremely vulnerable this season in her this $25,000-per-year position. Early on, bid for reelection. A few high-profile Governor - For the first time in the contest was expected to be a battle cases had gone against her office and the recent memory, there will be significant between two Republican candidates, decision to enter her name as a candidate primary races in both parties for this seat. Lake Tahoe entertainment lawyer John for University Chancellor added fuel to The front runner, not only within his own Mason and Las Vegas insurance execu­ the vulnerability fires. However, Del Papa party but in the entire contest, is the tive Bruce Layne. Both have been on tele­ appears to have obtained the backing of incumbent, Gov. Bob Miller. A recent poll vision and have been canvassing the state the state's top business and industry lead­ conducted by the Las Vegas Review-Jour­ for votes. However, recent polls in Clark ers, as she has in previous elections. nal and KLAS TV-8 showed Miller with County have shown former Las Vegas While she faces no primary challeng­ a comfortable lead over his Democratic city councilman Steve Miller leading in ers, Del Papa drew Carson City attorney opponent, Las Vegas Mayor Jan Jones. the Republican primary with neuro­ Bill Maddox in the general election. A But the Governor's lead had slipped in surgeon and University Regent Lonnie former U.S. Attorney, Maddox will push head-to-head comparisons with Republi­ Hammergren second. Since all of the can­ his experience as a prosecutor and attack can Cheryl Lau. didates have the fmancial wherewithal to the incumbent on a number of different Jones must make up significant ground stage mass-media campaigns, this race fronts. It remains to be seen, however, to catch Miller, but the Mayor's campaign won't be decided until election day. whether Maddox will be able to collect consultants are considered to be experts On the Democratic side, the only can­ enough cash to mount a viable challenge in grassroots campaigning and get-out­ didate left in the race is former Las Vegas against the always tough Del Papa. the-vote efforts. In addition, Jones has mayor Bill Briare (Councilwoman Mary started a barrage of television ads criti­ Kincaid dropped out before the close of Secretary of State - Two cizing Miller's record and sparks will filing). While he is widely respected for former legislators and a state government continue to fly up until election day. his years in the mayor's office, he hasn't veteran will vie for this important but

26 Nevada Business Journal • July/August 1994 low-profile office. Carson City Assem­ blyman Dean Heller will likely be the Republican nominee but the Democratic representative is far less easy to pick. .; ~ State Senator Tom Hickey and Karen Zupon Korcheck, currently an adminis­ --~~~~- - ~~~ trative aide to Del Papa, will slug it out in the primary. Money is traditionally hard to raise in this contest, so the candi­ date who best manages his/her meager resources will most likely be in Carson AUTOMATIC ROllOVIR City next January. Comstock Bank's got a construction loan that automatically rolls over for you faster than Fido! Treasurer-All indications are that Our automatic rollover loan simultaneously processes, finali zes and approves both your incumbent Bob Seale will coast to reelec­ construction loan and permanent loan before building begins. tion. He will have no primary and his only Don't pay twice for points, appraisals, credit reports and title insurance. opponent in the general will be Democrat Don't make two trips to your lender with fin ancials, William Harnma, who is little known and applications, tax returns , payroll deposits and such. Ca~ak not expected to put up much of a cam­ paign against Seale. Call631·1515 ~ ··!~~ Controller- Two Democrats will duke it out in the primary to earn the right to face incumbent Darrel Daines in the general. Reno Mayor Pete Sferrazza, a seasoned political veteran who two years Independent ago ran against Rep. Barbara Vucanovich, will face newcomer Mary Sanada, who currently works in Daines' office. Accountable

State Senate - Minority leader Dina Titus has assembled a credible slate Accessible of candidates in her attempt to take con­ trol of the upper house from majority leader and Reno Senator Bill Raggio. One Motivated key race in Clark County will be Senate District 5, where Republican Senator Bill O'Donnell is facing a tough challenge by telemarketer Steve Sisolak. In Washoe County, newcomer Emma Sepulveda will take on incumbent Sen. Randolph Townsend in a pivotal senate matchup. STEVE RYBAR State Assembly- The Demo­ crats are expected to maintain control of the Assembly, but not by as wide a ma­ for SheriH jority as last session. Sandra Tiffany is the only remaining incumbent Republican Paid by Committee to Elect Steve Aybar • Chairman: Mike Stanczyk from Clark County, so the G.O.P. can 1414 S. Maryland Pkwy. • Las Vegas, NV 89 104 expect a host of newcomers. •

July/August 1994 • Nevada Business journal 27 EXECUTIVE PROFILE

Dr. R.D. Prabhu devotes time to medicine and Asian American causes

It's 8 p.m. on an uncomfortably hot heard by our elected representatives, and July evening. The lights in the examine we have had success in this arena." rooms at the Lung Institute of Nevada Through his involvement with this and have long since dimmed, the staff has other organizations, Prabhu has been said their good-byes and the patient wait­ invited to attend functions at the White ing area resembles a school classroom House, and names as friends many of the after the start of summer vacation. nation's top Congressional leaders. The crackling sound of a voice pager Most recently, he was asked by the shatters the tomblike solitude, and the Secretary of State's office to attend a building's sole-remaining occupant gathering with the Prime Minister of reaches for the annoying but essential India, P.V. Narasimha Rao. device as he has more than 50 times "I met with the Prime Minister along during the day. with other Indian American leaders at a "Please call Valley Hospital ICU, White House luncheon hosted by Vice extension 4310," the pager commands. President Al Gore," Prabhu said. "I then ' Dr. R.D. Prabhu reaches instinctively had the very fortunate opportunity to hear • for the phone and dials the number. the Prime Minister speak at a joint ses­ Within seconds he is giving instructions sion of Congress." for the care of a patient. Just as quickly When he's not fighting for the causes he hangs up the phone and is back sign­ educate our members and exert political of Asian Americans, Prabhu does find ing forms , examining patient files and strength," he said. "So far it has been time to run his successful medical prac­ the host of other duties that come with very successful." tice, the Lung Institute of Nevada, which being one of Nevada's preeminent Prabhu was the group's first chairman he founded in 1991 along with partner pulmonologists. and helped put on a number of forums Dr. Michael Schlacther. When not in the office, Prabhu can where thousands of Asian Americans had Prabhu is the first doctor in Nevada usually be found at a meeting for what the opportunity to mingle and ask ques­ with training and experience in laser seems like his second career- serving as tions of Nevada elected representatives. bronchology. In addition, his is the only an advocate for Nevada's Asian Ameri­ But Prabhu's interest in politics doesn't practice in Las Vegas offering endobron­ can population in their fight to make stop at the borders of Nevada. He is cur­ chial brachytherapy, an advanced treat­ themselves a politically active force. rently president-elect of the national ment for lung cancer. "This country has been very good to Indian American Forum for Political The Lung Institute of Nevada also runs my family and me, but I know that unless Education and is poised to take leader­ the only doctor-owned sleep laboratory we work today to gain representation, ship of that group in August. The forum in Las Vegas. "Many people suffer from the future may not be so bright for our has more than 1 million members in the sleeping disorders and don't even realize children," he says. "Our people face glass United States and seeks to educate Indian that most of these problems can be ceilings every day where they cannot ad­ Americans about politics and the impor­ treated," Prabhu said. vance in their jobs because of their skin tance of getting involved. Aside from being a member of CAN­ color and appearance." "Asian Americans make up a signifi­ DO, Dr. Prabhu is also on the board of Prabhu is one of the founders of CAN­ cant part of this country's business sec­ directors for the Dr. Martin Luther King, DO (Concerned Asians for Nevada, tor," he said. "Many of our most suc­ Jr. Committee and a member of the Gov­ Development Organization), which is cessful entrepreneurs and small business ernment Liaison Committee of the attempting to unite all the many Asian owners are from this minority group. Yet American College of Chest Physicians. American organizations into one forum. they haven't been able to exert much For the past 10 years, he has donated his "Our goal was to pool our resources influence at the political level. We are time to see patients at the Veteran's and try to use our collective powers to seeking to make sure our issues will be Administration outpatient clinic. •

28 Nevada Business Journal • July/August 1994 SPEAKING FOR NEVADA

The Truth About Hospital Costs by Jerry Ash anyone, we dare to report some new and the lack of healthcare coverage and the President/CEO of interesting information presented in June effect of unpaid and underpaid Nevada Hospital to the U.S. Congress by the Prospective healthcare costs shifted to other payers is Association Payment Assessment Commission essential and critical to the process of (ProPAC), the federal watchdog for planning for healthcare reform. While the blue­ Medicare. Seeing the truth is difficult; accepting print for healthcare The report compares states on a it even more so. Hospitals understand reform twists its number of cost indicators. Here's what that well. Although the ProPAC statis­ way through the nation's capitol, it says about Nevada: tics seem to indicate hospitals are policymakers in Nevada await their Nevada ranks 24th in health spending "okay," we know we are still part of the tum. Whatever happens in Washington, per person- $1,730 ($1,848 nationally) problem, and part of the solution. We most believe this state's interest in which is for an individual's combined have looked into our future to see a healthcare issues will not remain on annual cost for hospitals, physicians healthcare system dominated by hold during the next legislative session. and prescription drugs. managed care. Most statistics suggest Hospitals understand the need for Nevada had the lowest spending that the result of a managed care system fundamental change and have advo­ growth between 1980-91 for combined will be further reductions in hospital cated it for four years. But, they fear healthcare services - 7.4 percent utilization, even closures. It's happening change driven by a mixture of political (9.3 percent nationally)- with hospital right now ip Seattle. expediency and public hysteria created care showing the smallest increase at A frightening prospect to hospital by misunderstanding and misinforma­ 5.9 percent (8.7 percent nationally). proponents, but we have come to tion. Hospitals have, after all, been Cost of physician services grew by accept the basic truth and are developing singled out as the primary culprit, 9.6 percent (10.4 percent nationally) and strategies to play a positive and because hospitals are the easiest targets. prescription drugs at a 7.6 percent rate still-important role in a new kind of In the past, data were always avail­ (9.4 percent nationally). healthcare delivery system. able to make "hospital bashing" the Hospitals in Nevada consumed the Physicians are even more apprehen­ political tool of choice; the most useful lowest share of the healthcare dollar of sive of the potential financial impact. being statistical information that any state-53 percent (60 percent nation­ Uneasy state and local government seemed to indicate Nevada hospitals ally) while Nevada physicians were officials face the specter of meeting had the highest charges and profit reported to consume the highest share - unresolved healthcare needs. Employers margins in the nation. Never mind that 42 percent (32 percent nationally). and employees who have opted out of the statistics were based on charges, not We could continue to bombard you the healthcare system are alarmed by payment, and that those profit margins with data until your eyes glaze over, but talk of mandates to achieve universal were a few dollars on several thousands. here in one report is enough information coverage. Everyone wishes this dilemma Plenty of other statistics were to show that problems with the health­ would just go away. available, but they were contrary to the care system go far beyond hospitals. It won't. We must overcome our fears ones that could generate the most public Nevertheless, one self-styled organiza­ and face our responsibilities head on, hysteria and pave the way for precon­ tion is now campaigning in Nevada to clearly, honestly and with the best inter­ ceived notions. When we dared point obtain signatures on a petition to force est of our communities at heart. We can them out, it infuriated the press and the the legislature to take a step back to the do it best as allies, not adversaries. We policymakers. simplistic and largely failed experiments can begin by agreeing on the facts. • During this political season, it is of the past- hospital rate-setting. heartening that (with some notable Beyond the fact that hospitals are tired Jerry Ash has been president/CEO of the exceptions) "hospital bashing" has not of being scapegoats, a continuation of Nevada Hospital Association (NHA)for six been the favorite tool of the candidates, such initiatives diverts attention from the years. The NHA represents nearly all the and that the Nevada Legislature has broader problems and deflects energy state's hospitals. Recently, the NHA become much wiser and more receptive from any effective solutions. broadened its membership by including 11 of to the whole truth. Understanding the true causes of the the state's managed care organizations and So, with the hope this won't upset high cost of healthcare, the reasons for formed the Council for Health Systems.

July/August 1994 • Nevada Business Journal 29 National Health Care • • • The 11 pie-in-the-sky// approach at what price? being taken by some advocates of national health insurance Twenty years ago, Congress was in revenues at $7.6 billion, less than one­ the throes of debating the issue of na­ third of the White House figures. underscores the wisdom of the tional health care. The lack of agreement A major element of reform in the on how to achieve this goal parallels the administration's plan has been the level issues facing this Congress as they de­ responsibility and costs assigned to the fabled ancient ruler who bate universal coverage versus guaran­ states. A Congressional Budget Office teed coverage, portability, pre-existing study - entitled An Analysis of the Ad- , conditions, accessibility, etc. and the two ministration's Health Proposal- states,. reduced all economic knowledge elements which are of manor concern to "Although the structure and standards for all- the cost and who will pay. the proposed health care system would It is generally agreed upon that what­ come largely from the federal govern­ to five simple words: ever the final version national healthcare ment, the states and alliances would have reform ultimately takes, it will incorpo­ the major responsibility for the day-to­ rate many of the proposals contained in day operation of the system. States would //There is no free lunch. 11 the Health Security Act. Further, some, also have substantial financial obliga­ if not all, of the revenue measures to tions. They would pay the regional alli­ offset the cost will parallel those identi­ ances for their share of premiums for fied in the Act. At this point in time, individuals and families who remained some 25 versions of the administration's eligible for Medicaid, and they would be proposal are being discussed. responsible for their share of Medicaid An analysis of the Joint Tax Commit­ spending on services not included in the tee study by the Tax Foundation reports, standard benefit for that group." "The Health Security Act contains 20 Until Congress decides what form tax provisions which in all are projected national healthcare will take, and the to raise $114.2 billion in five years be­ responsibility the states will incur is tween fiscal year 1996 and fiscal year defined, it is impossible to determine 2000." Unfortunately these projections what means the Nevada Legislature will can only be considered as best "guessti­ examine for funding the costs the state mates" because they are based on many will be required to bear. assumptions that cannot be quantified. The process of developing and imple­ Even the Joint Tax Committee noted menting national healthcare reform has some of the revenue estimates vary so many variables, a quantitative analy­ greatly from those done by the adminis­ sis is not possible. However, one thing is tration. Case in point: the Clinton ad­ certain: "There is no free lunch." • ministration projected a 1 percent pay­ roll tax would generate $24 billion Reprinted with permission from the July between the years 1996 and 2000 while 1994 issue of "Tax Topics", a publica­ the Joint Tax Committee estimates those tion of the Nevada Taxpayers Assocation.

30 Nevada Business joumal • july/August 1994 Sunrise Medical NEED A DOCTOR? Referral: 731-8888 Whether you need a referral for a physician, or have a medical question, our Health Information Line has the answer on 800 different topics. To get our free Health Information Line directory, which lists the four­ digit codes to access all 800 topics, drop by the information desk at Sunrise Hospital.

_.__,. e HOSPITAL & MEDICAL CENTER MAKE THE CALL: 3186 South Maryland Parkway 731·8888.(It's Free) Las Vegas , Nevada 89109 business indicators & anaiY.,sis

ndependence Day signals the high mark of summer and begins the midyear reevaluation of annual economic forecasts. While busi­ Nevada Taxable Sales ness and economic information collected each month is analyzed Quarterly. 1985 - 1994 and reported throughout the year, midyear is a good time to review I Billions and adjust annual forecasts made at the beginning of the year. During the first half of 1994, the Federal Reserve pushed interest rates upward. This was the biggest unexpected economic news. Most believed the Fed would follow past behavior. As such, attention focused on the signs of inflation, both the current and the expected near-term levels.

The usual measures of inflation, the consumer price and producer price S3 indexes, changed modestly during 1993. Furthermore, few expected

significant changes during 1994. Thus, fmding no signs of inflation S2 pressure, most believed interest rates would remain at or about the levels

that existed at the end of 1993. Sl However, the Fed, wishing to sustain economic expansion, acted preemptively to keep future inflation rates in hand. They pushed interest w~------~ rates upward during the first half of 1994 even as current measures of 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 inflation remained favorable. As a result, you fmd many making upward revisions in 1994 end-of-year interest rate forecasts. Moreover, they have less certainty in new forecasts because of the Peds new policies. Nevada Gross Gaming Revenue Should the Fed face a flight of funds to other countries because the Quarterly, 1985 - 1994 interest rate differential between foreign markets and the U.S. widens, Millions the Fed is likely to increase rates further to defend the dollar. In such an

event the Fed has few options since foreigners still provide a large share 52,000 of funds for debt refinancing. In addition, signs of inflation, either anticipated or real, could push the Fed to increase interest rates further. Of course, the Fed's concern for 51,500 inflation and international fmance comes at the expense of efforts to support domestic employment growth. In the face of such shifting eco­ $ 1,000 nomic conditions, year-end interest rates are likely to increase. A modest guess would be 0.5 percent higher (500 basis points) than current rates. The low rates of 1993 have been favorable to the nation's economic S500 recovery and Nevada's strong growth. In particular, the housing and auto sectors have grown faster than the national economy. In the first quarter of 1994 auto sales increased at a vigorous 9.5 million units. U.S. housing starts in April were up a strong 18.1 percent above a year ago. But conditions in Nevada have been even better. Permitting activity in southern Nevada during the first quarter jumped almost 100 percent Air Passengers above year-ago levels. It is not surprising that attention and concern Quarterly, 1985 - 1994 have focused on recent Fed actions since the health of these sectors often Millions depends on the availability and cost of fmancing. Both the national and state consumption sectors have also improved as the economic expansion continues. Nevada taxable sales increased by

12.3 percent for April. Taxable sales collections were up by 16.1 percent McCarran in Clark County and 7.9 percent in Washoe County. By far the most significant measure of the state's economic strength is gaming revenue. Southern Nevada continues to experience double-digit monthly gaming revenue growth. Washoe County gaming revenue in­ Cannon creased 7.9 percent in April. But sustaining such rates may prove diffi­ cult in the months ahead. Furthermore, not all areas of the state's gaming / economy have shared equally in this boom.

0 ~------_/ R. Keith Schwer, UNLV Center for Business & Economic Research 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994

32 Nevada Business Journal • July/August 1994 LATEST PREVIOUS YEAR CHANGE DATE UNITS PERIOD PERIOD AGO YRAGO UNEMPLOYMENT Nevada May, 1994 % 5 .3 5 .3 7.2 -26.39% los Vegas May, 1994 % 5.2 5.3 6.9 -24.64% Reno May, 1994 % 4 .4 4.6 6.2 -29.03% u.s. May, 1994 seasonally adj. 6 .0 6 .4 6.9 -13 .04% RETAIL ACTIVITY Nevada Toxoble Soles April, 1994 $thousand 1,511 ,537 1,659,999 1,345,595 12.33% Clark County April, 1994 $thousand 932,969 1,022,848 803,540 16.11 % Washoe County April, 1994 $thousand 259,364 290,1 58 240,330 7.92% U.S. Reta il Soles April, 1994 $mill ion 183,608 185,000 170,627 7.61 % GROSS GAMING REVENUE Nevada May, 1994 $thousand 581 ,067 589,724 539,500 7.70% Clark County May, 1994 $thousand 449,740 462, 168 399,369 12.61 % Washoe County May, 1994 $thousand 79,240 78,246 82,845 -4 .35% CONSTRUCTION ACTIVITY los Vegas Area New Res idences 1st qtr 1994 #permits 4,860 4, 103 2,451 98.29% New Commercial Permits 1st qtr 1994 #permits 128 138 162 -20.99% Reno Area New Res idences 2nd Half 1993 #permits 1,469 962 684 114.77% New Commercial Perm its 2nd Half 1993 #permits 53 40 40 32.50% U.S. Housing Storts April, 1994 thousand 1,455 1,492 1,232 18.10% Totol Construction April, 1994 $billion 508.5 505.4 449.1 13.23% HOUSING SALES los Vegas Area Average Soles Price 111 1st qtr 1994 $ 144,984 135,755 135,584 6.93% Average Cost/Square Foot 1st qtr 1994 $ per ~ q . ft. 79.31 73.74 79.29 0.03% Average Mortgage Rote 121 1st qtr 1994 % 7.19 7 .27 7 .62 -5.64% Washoe County Average Soles Price Ill 2nd Ha lf 1993 $ 170,325 157,825 151,403 12.50% Average Cost/Square Foot 2nd Half 1 993 $ per sq . ft . 96.88 92.42 90.18 7.43% Average Mortgage Rote 121 2nd Half 1993 % 7.20 7.70 8.30 -13 .25% U.S. Home Soles April, 1994 thousand 683 733 685 -0.29% TRANSPORTATION Totol Passengers 131 McCarron Airport, LV 1st qtr 1994 passengers 6,322,338 5,854,948 5,212,601 21.29% Connon Airport, Reno 1st qtr 1994 passengers 1,296,464 1, 196,677 1,106,402 17.18% State Taxable Gasoline Sales April, 1994 thousand gal. 59,445 62,936 57, 103 4.10% POPULATION ESTIMATES Nevada Ju ly, 1993 people 1,398,400 1,343,930 4 .05% Clark County Ju ly, 1993 people 898,020 854,780 5.06% Washoe County July, 1993 people 271,770 266,500 1.98% NATIONAL ECONOMY Consumer Price Index 141 May, 1994 1982-84= 100 147.5 147.4 144.2 2.29% Money Supply- M 1 April, 1994 $billion 1 '141.3 1,142.4 1047.1 9.00% Prime Rote May, 1994 % 6.75 6.25 6 .00 12.50% Three-Month U.S. T-B ill May, 1994 % 4 .19 3.74 2.96 41 .55% Gross Notional Product 1st qtr 1994 $billion 6,617.6 6,526.5 6,261.6 5.69%

NOTES: (1) houses, condos, townhouses; (2) 30 yr. FHA; (3) enplaned/deplaned passengers; (4) all urban consumers SOURCES: Nevada Dept. of Taxation; Nevada Employment Security Dept.; UNLV, Center for Business and Economic Research; UNR, Bureau of Business and Econom ic Research; US Dept. of Commerce; US Federal Reserve. COMPILED BY: UNLV, Center For Business and Economic Research

July/August 1994 • Nevada Business journ al 33 monitors appropriateness and quality of Registered nurses and physicians have services. Reviewing the patients' care access to a fully relational data base that minimizes unnecessary procedures, treat­ allows them to identify trends and ana­ ments and inpatient hospitalization. The lyze the overall effectiveness of each pro­ staff also initiates discharge planning and vider. "We also provide custom reports outpatient care. Catastrophic case man­ for employers and payers," says Dan agement has demonstrated remarkable Helmchen, data team leader. cost savings. One employer group with Helmchen oversees the processes re­ more than 1,000 employees has docu­ lated to informational systems within the mented annual healthcare cost savings in company. "My team works with the clin­ excess of $1 million dollars. ical team to ensure the care is timely, Briefs Health Care Inc. has achieved in excess and demonstrates results," he said. of 25.4 percent savings through the com­ "We are proud of our customer-driven pany's workman's compensation panel. system," said Linette Smith, customer Increasing efficiency the Included in this customized panel of pro­ service team leader. "Our organization key to reform at HCI viders is the Cooperative Association of has a long list of value-added services Chiropractic Physicians. which are an integral component of our NOW more than ever, healthcare pur­ overall system of caring." chasers are highly informed, educated Horizon Compcare consumers of a product which was pre­ viously understood, developed and sold awarded SIIS contract SHS declares second only by persons "in the health care field". WHEN the 1993 Legislature enacted Sen­ quarter profit The need to restructure the health care ate Bill 316 to reorganize the Nevada SIERRA Health Services, Inc. (NYSE: system is undeniable. Experts agree it is State Industrial Insurance System (SITS), SE) reported that net income for the quar­ only by increasing the efficiency of the many were uncertain whether managed ter ended June 30, 1994 was $5,501,000 present systems that the goals of quality care would be an effective solution to compared to a net income of $4,156,000 care, optimal access and cost control will the system's failing finances. To the sur­ for the second quarter of 1993, a 32 per­ be achieved. Insurance carriers, managed prise of skeptics, managed care proved cent increase. Earnings for the second care organizations and providers of more successful than anticipated. quarter of 1994 were $.44 a share versus healthcare services must demonstrate ac­ Horizon Comprehensive Care, a man­ $.34 a share for the second three months countability to purchasers of healthcare. aged care organization awarded a two­ of 1993, a 29 percent increase. Revenues Founded in 1984 as the state's first non­ year contract with SIIS, has an extensive for the second quarter of 1994 were profit healthcare management and pre­ licensed professional staff available to $72,683,000 compared to $63,463,000 for ferred provider organization, representing employers and injured workers at all the same three-month period last year, an a coalition of employers, Health Care In­ times. The company has developed a pro­ increase of 15 percent. corporated attributes much of its success gram that anticipates the needs of the For the six months ended June 30, 1994, to a well-integrated board of directors and employer, the injured worker and net­ net income was $9,976,000 compared to medical review committee. The medical work provider. $7,806,000 for the period ending June 30, review panel includes over 100 physi­ The company also provides utilization 1993, a 28 percent increase. For the first cians encompassing all specialty areas review, case management, bill reprising half of 1994, earnings per share totaled and nurse managers with a minimum of and additional services for self-funded $.80 versus $.64 for the comparable pe­ 15 years' experience in utilization review groups and independent insurers. riod in 1993, a 25 percent increase. and case management. "In coordinating the clinical program As ofJune30, 1994, membership in the Participating employer groups con­ for Horizon Comprehensive Care, it is company's fully insured products stood tracting with Health Care Inc. create their essential to provide employers with di­ at 145,573 compared to 131,760 for the own individualized programs and are rep­ rect access to a professional medical first six months of 1993. In addition, the resented on the organization's board of staff," states Clinical Services Team company had 128,597 members enrolled directors. Should an employee require Leader Janie "Smiddy" Lamb, RN, BSN. in its administrative services product by hospitalization or outpatient care, Health "Our physician directors review every the end of the first half of 1994 compared Care Inc. reviews the treatment plan to out-of-work claim and, when indicated, to 60,595 members one year ago. Of that confirm it is medically necessary. 'partner' with the employer and the treat­ 128,597 members, 67,364 were enrolled Health Care Inc.'s staff reviews medi­ ing physician to create the best possible in the managed care worker's compensa­ cal records, expedites treatment, and outcome for injured workers," said Lamb. tion program. •

34 Nevada Business journal • July/August 1994 Providing the best possible care for your heart requires a blend of advanced diagnostic, surgicaL and rehabilitative technologies and a team of highly skilled and experienced physicians, nurses, and technicians. Maintaining a position of leadership in providing such care requires vision, sensitiv­ ity, dedication, and commitment.

At Desert Springs HospitaL we've acquired the technologies, assembled the team, and applied these qualities to our com­ plete range of cardiology services for greater efficiency and better performance.

While Desert Springs Hospital is dedicated to diagnosing and treating heart disease, it is only part of the story. Our first priority is prevention and detection of heart disease. That's why vve offer comprehensive cardiac screening and rehabili­ tation programs as well as our Chest Pain Center.

But perhaps more than any other facet we are proud of our reputati on for personalized patient care and service. At the core of each procedure is someone who cares.

Desert Springs Hospital - delivering the quality healthcare our community expects and deserves. DESERT SPRINGS HOSPITAL 2075 East Flamingo Road I las Vegas, l\TV 89119 Hospital ·· Happenings

Valley Hospital wins prestigious award Valley Hospital Medical Center was the sole recipient in Nevada of the 1994 United States Senate Quality and Pro­ ductivity A ward. Valley Hospital receives the 1994 U.S. Senate Quality and Productivity Award. (l tor): The award recognizes organizations for Sen. Harry Reid; Claus Eggers; Karla Perez; and Sen. Richard Bryan. their top quality and productivity efforts. The award program began in 1982 with expansion also included a new lobby, a cellent strategic planning abilities in both the U.S. Senate's desire to help reverse larger cardio~ogy department and new residential and commercial development the national decline in productivity and cardiac learning center, an expanded and management companies. His exper­ to enhance the United State's position as emergency room and new "FastER". tise extends into law and accounting com­ a competitor in the global marketplace. "With the rapid population growth, we bined with strong marketing, negotiating Applicants are evaluated on the fol­ must remain one step ahead, and be pre­ and interpersonal skills. lowing criteria: leadership, information pared to meet the changing healthcare Douglas M. Todoroffbrings extensive and analysis, strategic quality planning, needs of our community," said Eggers. management experience to the board of human resource utilization, quality as­ directors. He is president of Mercier Man­ surance, quality results and customer sat­ agement Company, a private investment isfaction. Finalists are evaluated on-site New board members at company and is currently on the board so judges can see the implementation of St. Rose Dominican of directors of MIKOHN Gaming Cor­ programs. The process includes random St. Rose Dominican Hospital recently poration. Todoroff is an active member interviews with employees to determine welcomed four new members to the of the community. He serves on the ex­ their level of understanding and day-to­ hospital's board of directors. ecutive board of the Boulder Dam Area day quality improvement. Robert K. Ritchey, M.D. specializes Council of the Boy Scouts of America, "This award would not have been pos­ in family practice medicine and has been board of directors for Catholic Services sible without our most important asset, a member of the St. Rose Dominican Appeal in the Reno-Las Vegas Diocese, our employees," said Claus Eggers, man­ Hospital medical staff since 1989. Leadership Council for the Leadership aging director. "We will remain diligent Ritchey has also served on several hos­ Las Vegas Program of the Chamber of in our efforts to continue to offer the best pital medical staff committees. Commerce, and has served on the finance quality healthcare service in Nevada." Eric A. Traub is president and CEO committee at the hospital. Valley Hospital recently completed an of American Nevada Corporation, devel­ Robert L. Forbuss is president and $18 million expansion project, with the oper of the Green Valley community in chief executive officer of Mercy Medi­ addition of a two-story tower and 100 Henderson. Traub has 28 years' entre­ cal Services. Under Forbuss' leadership, beds, bringing the total beds to 398. The preneurial experience combined with ex- Mercy Medical Services has grown from

36 Nevada Business Journal • July/August 1994 a small ambulance service to one of the largest and most respected in the nation. In 1991, Mercy Medical Services re­ ceived the United States Senate Quality and Productivity Award for Excellence. Under the guidance of those who served on the fiscal year 1993/1994 board of directors, St. Rose Dominican restruc­ tured and expanded. New services in­ clude cardiac catheterization lab, inter­ ventional radiology and angiography, mental health resources, home health ser­ vices, transitional care and plans for three new medical ambulatory care centers. St. Rpse Dominican is the only not­ for-profit, non-tax supported, religiously affiliated hospital in southern Nevada.

Rehabilitation Hospital marks anniversary One year after opening, the Rehabili­ tation Hospital of Nevada - Las Vegas has established itself as a vital asset in The labor/delivery suites at Lake Mead Hospital's year-old Women's Plaza feature a the southern Nevada area. pleasant homelike atmosphere. Described by its chief officers on open­ ing day as a "dream come true" for those who work in rehabilitation, the Rehabili­ The Las Vegas medical community has hospital that has undergone extensive tation Hospital of Nevada is Las Vegas' shown widespread approval of the hos­ renovation in nearly every quarter. The only freestanding hospital for rehabilita­ pital's teamwork approach which in­ result provides comfort for patients and tion for those who have experienced a cludes a physician, nurses, therapists, so­ their families while offering up-to-date disabling injury or illness. Other unique cial workers and psychologists. To date, diagnostic and surgical technology. programs and services include pain man­ the hospital has a medical staff of 62 The most current and exciting addition agement, ventilator management/wean­ doctors and 35 allied professionals which to the hospital is the Critical Care Unit ing, pulmonary functional rehabilitation, includes physical, speech, occupational, complete with state-of-the-art computer­ outpatient vestibular rehabilitation, as recreational and audiology therapists. ized technology equal to the nation's well as extensive outpatient services. High marks are awarded from local major metropolitan teaching hospitals. "Before this hospital opened, patients healthcare insurers who find that reha­ The Women's Plaza is one of the most experiencing traumatic brain or spinal bilitation hospital services cost consider­ modern facilities in the city with four cord injuries had to go to Southern Cali­ ably less than traditional inpatient ser­ labor and delivery suites, 20 postpartum fornia or Utah for rehabilitative services," vices at acute care hospitals. beds and a surgical suite. says Dr. Ralph Laraiso, Rehabilitation The new fourth floor of the tower opened Hospital's medical director and physia­ Lake Mead Hospital in July and features a long-awaited pedi­ trist specializing in physical medicine and atric unit. With these new additions, the rehabilitation. continues to grow hospital has a total bed-count of 190. A state-of-the-art facility, the 56,454- "A healthy choice for you" has been In April of this year, Lake Mead Hos­ square-foot Rehabilitation Hospital of­ Lake Mead Hospital's slogan for the past pital was acquired by OrNda Healthcorp, fers a 14-bed brain injury unit which four years. As a testament to the hospital's the filth largest investor-owned healthcare works with patients recovering from commitment to this simple philosophy, corporation in the United States. Shortly strokes, traumatic brain injury or other the facility's progress and growth have after the acquisition, Pulse Health Ser­ neurological disorders. Treatment focuses been nonstop. What was once known as vices, an OrNda-owned home health care on improving memory, concentration, at­ Community Hospital of North Las Vegas agency, joined the complement of services tention, motor and problem-solving skills. no longer exists. In its place stands a at Lake Mead Hospital. •

July/August 1994 • Nevada Business Journal 37 ••• • huh? by George Knapp

ADVENTURES IN BUSINESS TRAVEL

I DON'T TRAVEL DURING one flight last year, stories and a possible docu- off. There were no cheers the plane was struck by light- mentary project. Three however, since most of the WELL. In some ning three times. On another unsuspecting travel com- passengers had been mummi- flight, the man in the seat next panions were part of the fied. The 300-pound woman in previous lifetime, to me stood up, clutched his entourage. We were excited, the seat across from me, for chest, and died. I was pressed anxious, and optimistic ... example, was transformed into I must have into service by the flight for the first 10 minutes or so. a stick of beef jerky. I sug- murdered a help- attendants to carry the body to Then, once again, the Grim gested she re-tighten her seat- the back of the plane, a gesture Reaper chose to intervene, belt, but there was no response. less travel agent which earned me all the honey- seizing control of our seem- We arrived in Houston roasted peanuts I could eat. ingly-innocent itinerary. relatively intact, but 90 or kidnapped the Lost luggage? Enough to fill As is customary, I walked minutes late. In his best day, a Samsonite factory. Lost onto the plane three minutes O.J. Simpson never zipped child of an airline money, lost travelers checks, before the scheduled takeoff. through an airp_~rt as quickly lost hotel reservations, delayed Every seat on the Continental as we did, to no avail. We executive. The flights, canceled flights, flight to Houston was filled, missed our connecting flight to London. Don't worry, they . karmic conse- broken-down rental cars, food and the air-conditioning had poisoning, bone-jarring not yet kicked on. After about said, there's another flight quence of these turbulence, heat waves, 20 minutes of sitting on the tomorrow. Tomorrow? thunderstorms, mud slides, 120-degree tarmac, the pilot Tomorrow simply wouldn't past sins is that earthquakes, crooked cabbies, informed us that one of the do, we said. Over the next five corrupt cops, bar fights with doors wouldn't close. Engi- hours of heated negotiations, every trip I take burly natives, pickpockets, neers were summoned. Calls we managed to convince the klepto maids, aggressive were made to the experts in Continental folks that we were is a disaster. beggars, Times Square junkies, Houston. Muffled consulta- big-time journalists on a mysterious stains on the sheets, tions were held in front of the deadline and that we had to Unfortunately, and unidentified hairs on the offending orifice. Still, the get to London at once. They I travel a lot. pillows. You get the picture. door would not cooperate. fmally tired of our harangue People who know me well In the meantime, every and booked us on an Air refuse to travel with me. They person on the plane learned France flight to Paris, then make alternate arrangements what it means to be a lobster. a British Airways jaunt to and say they'll meet up with Rivulets of sweat streamed Gatwick Airport. The trip me somewhere on the road. down the aisles. Otherwise from Las Vegas had taken a Who can blame them? But just modest passengers peeled off mere 31 hours, and we looked when I thought I had seen it all their clothing until the entire like escapees from the mosh -every natural, unnatural, or coach section looked like a pits at Woodstock II. supernatural calamity which weekend at Bob Cuccione's We checked into a hotel in could possibly happen to a place. Bags of microwave the belief that we could catch a single person on a single trip- popcorn could be heard train the next day and hook up my luck took a downward dive exploding in the galley. Yes, with the group whose exploits like an out-of-gas Cessna. The I was glad I use Dial. Regret- we hoped to videotape. No Griswold family can't carry tably, the same can't be said such luck. We awoke to my air sickness bag when it for everyone else. discover that a one-day, comes to travel travails. After an hour-and-a-half of nationwide train strike had The plan was to journey to enduring the acrid odor of been called. The entire country England and Scotland for 11 boiling brain fluids, the door was paralyzed. But what a days to pursue a few news was fixed and the plane lifted civilized labor action it was.

38 Nevada Business Journal • July/August 1994 The rail workers had politely Annada had just been de­ train strike announced the work stoppage feated. Shakespeare hadn't was called on several days in advance, and it even written Hamlet yet. And the same day was only for a single day- this we had to choose this time to we planned to get day. We were the only people visit the city? out of the city via the in the British Isles who didn't What makes this worse is rails? As Dave Barry is see it coming. Jolly good. that London hotels are not air­ fond of saying: "I am The next several days can be conditioned. The hotel we NOT making this up." condensed into a series of stayed in must have been built We wanted to get home seemingly unrelated observa­ prior to the pre-Armada heat in the worst way, but one tions. The British people, for wave because the windows hurdle still remained. example, are wonderful and were so small they allowed for polite and truly seem to like virtually no air circulation. We Americans, which is a rarity would have sweat a lot, but all these days. But, they have no of our bodily fluids had been concept of good service. I baked out while we were on don't know if the service is Las Vegas tarmac. The only bad because no one tips, or if place in London which had air­ no one tips because the service conditioning was a movie is so bad. As bad as the service theater. I endured seven bump us up to something is, it is only slightly better than showings of the Flintstones, called Business First, and it most of the food. Fortunately, just to keep cool. turned out to be the single " As Dave the British are generally affa­ The elevator in our hotel was most enjoyable plane ride I've ble, even when they drink too originally designed to be a ever had. You could drive a Barry is fond much, which is all the time. shoebox for Henry VIII. Twice golf cart between the seats and Because most pubs close by 11 we found ourselves stranded still have leg room left over. of saying: p.m. , British boozers pound between floors, squished into Little individual TV screens down drinks as if the V-2's the shoebox like Spam in a pop up from the console, "I am NOT might land at any moment. can. The hotel itself was allowing the passenger to They treat ice as if the cubes located in what apparently is choose from an endless array making this up." were culled from South London's construction zone. of movies. Gourmet food, a African mines. Asking for ice The sweet sound of jackham­ wine list. It was tremendous. cubes is akin to questioning the mers tickled our ears round the I found myself wishing I had Queen's sexuality. Beer is clock. It really didn't matter spent 11 days flying around served at a temperature that much, since the tenants in in this plane instead of ever comparable to a bucket of spit the room next to ours were a touching down. which has been sitting all day dysfunctional family of rhinos. As a postscript, there is on the asphalt of the Thomas Oh, did I mention that Arab some truth to G.B. Shaw's and Mack parking lot. terrorists decided that a 400- observation that England and Because we were already a year heat wave would be an America are two countries few days behind schedule, we excellent time to bomb Jewish divided by a common lan­ had to skip our visit to Scot­ targets in London, including guage. If you ever get to land and went to London the Israeli embassy, just a few England, and if your visit instead. In keeping with my blocks from our hotel? And did does not occur during a heat string of good fortune, London I mention that the entire wave, never tell anyone you was embroiled in its most population of Englarid was in a intend to put on your jacket intense heat wave in 400 years, total funk because the national to go for a walk. The word according to tourism officials. cricket team had just lost to "jacket" to the English means (Do they really have weather South Africa, the equivalent of baked potato. You'd look records that date back that Reno beating Las Vegas in a very funny wearing a baked far?) Think about it. Four craps game? And did you potato at a screening of the hundred years ago, the Spanish know that another one-day Flintstones. •

July/Augu st 1994 • Nevada Business Journal 39 To The Sierras