Health Care Quarterly:

Growth in the health care community benefits Las Vegas as a whole

As Southern Nevada grows, so does the demand on the local health care system. At the same time, as the local health care system itself expands, so do its contributions to the community and to Nevada itself.

In the race to meet a growing demand for health care services, Southern Nevada has seen a number of major developments in recent years. Examples include partnerships between health care providers and local medical schools and the city of Las Vegas’ designation of a “Las Vegas Medical District.” The establishment and growth of the UNLV School of Medicine and the expansion of schools like Touro University Nevada, Roseman University of Health Sciences College of Medicine, Nevada State College School of Nursing and the University of Nevada School of Medicine are already making a significant impact.

The same can be said for the ambitious recruitment and community collaboration efforts of local health care providers like Southwest Medical Associates, part of OptumCare. In 2018, OptumCare Nevada and Southwest Medical welcomed 95 new health care providers.

Jeremy Aguero, principal analyst for Applied Analysis, a leading local economic, fiscal and policy research firm, has seen a cluster effect of business growth encouraged by developments in a particular industry or sector of the economy.

“Tesla in Northern Nevada is a good example,” he said. “There’s been a great deal of progress since 2011, and the support provided through Gov. Sandoval and the Nevada Governor’s Office of Economic Development.”

Not including Tesla itself, an additional 8,200 jobs and $466.3 million in annual payroll are supported at other local businesses in Northern Nevada, sparked by about $6 billion in capital investment by Tesla and its partner Panasonic, which have developed a massive Gigafactory outside of Sparks to produce batteries for Tesla’s electric cars and energy storage systems. Its construction supported 17,150 direct and 7,938 indirect person-years of employment (i.e., one person employed for one year).

“What you generally have is an employer or group that becomes the center — or nucleus — for a cluster business,” Aguero said. “I think, overall, the creation of the medical district is something that was a long time coming for Southern Nevada. It is absolutely the right step for the city of Las Vegas and Southern Nevada as a whole.”

The medical district was established in 2002 by the city of Las Vegas and includes 214 acres around UMC and Valley Hospital and another 460 acres near Martin Luther King Boulevard and Symphony Park.

In recent years, the newly launched UNLV School of Medicine partnered with UnitedHealth Group, which includes Southwest Medical, part of OptumCare. The partnership is powered by a grant provided through the United Health Foundation.

Longtime Las Vegan Dr. Robert McBeath, Southwest Medical’s president and CEO, explains that the grant supports the development and implementation of specialty programs and other initiatives that will integrate local medical students with the local health care community.

“With primary care physicians as instructors, or ‘preceptors’, and a primary care health center as a home base, each student becomes a key member of an interdisciplinary team providing comprehensive care to patients,” McBeath said. “We continue to collaborate and work closely with them.”

The grant also aids in the building of three multispecialty community clinics by the medical school, which will offer a full complement of primary care and basic specialty care services.

The new UNLV School of Medicine will help considerably in the years to come, producing more doctors to help address a continued shortage of health care providers in Southern Nevada.

In the meantime, demands on the system continue to grow, and Southwest Medical continues to partner in clinical education across the Las Vegas Valley, with a financial donation to the Touro University Nevada Physician Assistant Studies Program and working with Universal Health Systems hospitals to be the clinical site for its approved Family Practice and Internal Medicine residency longitudinal ambulatory care clinics.

Southwest Medical’s program recently brought in six Touro students to spend the majority of their clinical year training in the company’s facilities, before going to work for the practice by graduation. Southwest Medical will also be the clinical site for the UHS-approved family practice and internal medicine residency. This program will be producing 60 new family practice doctors and 120 internal medicine interns and residents that will take their place at medical practices within the Las Vegas community and beyond. This residency program pays its advanced practice clinicians a stipend while they train.

Jennifer Bergdoll is vice president of clinical talent acquisition for Optum, which is making increased investments in both physician retention and recruitment. She expects 2019 to follow a growth pattern similar to last year, when the company had one of its best years ever for adding health care providers.

“The way we are trending, we project bringing on another 90 to 100 health care providers this year, with approximately 44 of them being physicians,” Bergdoll said.

The term health care providers typically refers to not just physicians, but also what are called “advanced practice clinicians,” such as nurse practitioners (NPs) and physician assistants (PAs).

“Many of our providers in the community are now training in Southern Nevada,” Bergdoll added. “To take advantage of this growing opportunity, we’ve expanded our teaching partnerships with Touro University and expanded other partnerships with UNLV School of Medicine, as well as the Valley Health System family medicine residency program, which starts in July 2019 and will be the largest family medicine residency program in Nevada.”

Despite diligent efforts by area health care providers and medical schools, Aguero explained that “at the moment, the local health care industry is only about 70 percent of what it should be for an economy our size. There is capacity within the state’s economy for health care services and the economic development associated with it.”

Stacy Scheer is vice president of the Healthcare Services Division for Colliers International, a leading commercial real estate services firm in Southern Nevada. She has witnessed newly generated interest from developers in and around the medical district, largely driven by the growth of the UNLV School of Medicine and demand for new retail amenities and parking facilities.

Ancillary medical uses, expansion of existing businesses and relocations by businesses taking advantage of the governmental incentive programs available in the medical district have also had a positive effect. Research and development facilities are taking note, such as Jubilee Clinical Research, Inc., a multi-specialty clinical research facility opening in the district in late 2018.

“UNLV and related facilities have absorbed a significant portion of existing inventory in response to their own growth over the past three years,” said Scheer, explaining that “absorption” refers to existing commercial real estate space that has been leased or occupied. “Vacancy of commercial medical office inventory in the Las Vegas Medical District is now at its lowest since 2009. It is currently at 8.6 percent as of Q4 2018, down from 18.1 percent during the peak of the recession. Which is not to say that new construction has not taken place in and nearby the medical district. Steinberg Diagnostic Medical Imaging was the first brick-and-mortar addition to the medical district in 2015, and most recently, Dignity Health completed its 36,672-square-foot micro-hospital located at 4980 W. Sahara Ave. in 2017.”

Another recent development includes construction in the area where Southwest Medical first opened its doors, at the gateway to the medical district. Work has been taking place over the past year at Rancho Drive and Charleston Boulevard for the OptumCare Cancer Center, a new 55,000-square-foot treatment center that provides a new treatment option for patients. The Cancer Center opened its doors in December and will continue expanding services in three phases, adding medical oncology in December and additional cancer care services and treatments expected to be in place by May 2019. Patients at the center will benefit from a wide range of personalized services offered under one roof, including medical oncology, surgical oncology, chemotherapy, immunotherapy, breast care, imaging, nutrition and psychiatric services, palliative care laboratory services, and a patient and family resource library.

Aguero noted that the UNLV School of Medicine promotes exactly this type of synergy. It facilitates growth of health care practitioners within a specific area of need.

“It’s analogous to the William S. Boyd School of Law when it was created 20 years ago,” Aguero said. “It enables us to retain and develop local talent. With medical residencies and graduate medical education, we can grow our workforce locally.”

Aguero added that health care has been one of the fastest-growing sectors of the local economy during the past 10 years, even witnessing an increase during the previous recession. Since 1998, he said there has never been a period in which the health care sector has reported a year-over-year decline in employment.

From November of 2017 through November 2018, he said 4,400 jobs have been added in Clark County’s health and education services sector.

“If we look at employment in health and education services, the vast majority is in health-related activity,” Aguero said. “It comprises 103,000 jobs in Southern Nevada.”

He added that “the beautiful thing is that so many of the businesses that grow in and around these districts are small business. The vast number of businesses in our state have fewer than 100 employees. That major investment in the school has major spinoff effects, creating jobs in nearly every sector of the local economy.”

Commercial real estate professional Stacy Scheer has witnessed the first stirrings of that spin-off effect, recently handling a parking garage project that will serve the school, while also featuring both retail and medical space on the first level. The new project is located at 400 Shadow Lane in the Las Vegas Medical District.

“I do anticipate more ‘from the ground up’ development happening,” she said. “Many existing buildings are obsolete for modern medical uses and larger spaces are needed by growing practices. You will see higher density and more high-rises to accommodate parking. Much of it will be tied to the school, but I think you will see that for the growing practices and the existing hospitals in the medical district. Housing is not yet (part of that mix), but will be there eventually to house employees working there and housing for students who will be learning there. And, of course, retail follows rooftops.”



Dr. John Rhodes is the senior medical director, Mountain West Region, for Southwest Medical Associates