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Becker’s Healthcare Podcast
Anna Roth, President and Chief Executive Officer at Tahoe Forest Hospital District
00:16:17
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- [00:00]
A
This is Scott Becker with the Becker Healthcare Podcast. Thrilled today to be joined by the CEO and president of the Tahoe Forest Health System. We're joined today by a brilliant leader, Anna Roth. Anna took over the role as president CEO not that long ago. She's had a fantastic career. She probably knows our close colleague Carmela Coyle and we'll talk to her more about that as well. Anna, can you take a moment and tell us a little bit about yourself and about Tahoe Forest Health System?
- [00:34]
B
Yeah. And thank you so much for having me join you all today. And certainly I'm, I'm delighted to be here in my new role. In fact, I am spending my 100th day, this is my 100th day in my new role as President and CEO of Tahoe Forest Health System. And just a little bit about our system. We are a, we serve a community across state, six rural counties in California and Nevada covering about 3,500 square miles. We have two critical access hospitals, three urgent care clinics, the Jean Upshaw Memorial Tahoe Forest Cancer center, as well as several other programs including our World Class orthopedics program. So I'm really proud to be here to join the team in service to both our permanent residents who live here and the many, many visitors who come to visit the north Lake Tahoe area year round.
- [01:32]
A
Well, fantastic. In a great, great system. Now I'm going to ask you a question and this may be challenging and I'm going to ask you a serious question. The first question is Gene Upshot is famous to my generation if you're an L A Raiders fan or a sports fan. And also I think he led the players union in the NFL for years. A brilliant, brilliant leader in person. What was his connection to the Tahoe Forest Health System or any sense of the history in that? And it's probably an unfair question for somebody who's only been there for 100 days.
- [02:06]
B
Well, I, I want to say a couple of things. There's lots of people who have lots of connections with our system because we, we are located in a world class destination. So and I will say without sort of, you know, you can read more about actually Gene Akshaw's connection with our cancer center. His foundation has certainly been a major, was a major supporter as well as the NFL foundation. But I do want to make one correction. I come from the East California Bay area and for me it will always be the Oakland Raiders.
- [02:43]
A
We could not agree with you more. And then I'll ask you another question. I Are you or are you not an Al Davis fan. Because that's really the heart of Raider Nation and how you feel. Because they're now the Las Vegas Raiders, aren't they? But. But are you or not an Al Davis fan? Because he was sort of that the heart and soul of the Raiders, but also kept on trying to move the Raiders away. Any thoughts there about Al Davis?
- [03:06]
B
I will refrain from answering that question, but I will just say that I am. I will always see the Raiders as an Oakland team, as I will always see the A's at baseball as an Oakland team. And I'll leave it at that.
- [03:21]
A
We could not agree more about the Oakland Raiders. The, the black and Silver and the in the Oakland A's, even back in the Charlie Finley days. Such great fun, fantastic Vita Blue, Reggie Jackson back in the day. Amazing. Let me ask you a different question. So you're through 100 days. There's been so much written in business and there's a famous book on the first 90 days. And everybody takes those first hundred days in a different way. The traditional manner has been sort of think, figure it out, get to know what's going on, all those kinds of things. Then there's the President Trump manner, where you start off on day one like a bull in the China shop. Where do you come out on how you spend the first 100 days as a leader? And it's not a negative politically or positive one way or the other about President Trump. It's just that never seen anybody take it like that. But what is your perspective on how you get acclimated those first 100 and how you start to do work?
- [04:19]
B
Yeah, it's a great question. And I, you know, for me, and I would just say it depends on, you know, where you're going and how you're learning. For me, this has been a big change. So I come from, I'm coming here from, via the San Francisco Bay Area, running a very large comprehensive integrated health system, and they're now moving up to the mountains. And I will just say, like many people in the Bay Area, I've, you know, I've always owned a Jeep, but never actually needed a Jeep. So part of my first hundred days, because I arrived in the middle of a snowstorm, was literally learning how to actually do, you know, your daily work in the middle of a snowstorm. But I would say that I, I've said my first hundred days, you know, I, I would say more the, the former example you gave where I have been doing a lot of listening, a lot of learning, you know, navigating, kind of not only this mountain system, but the mountain roads. Literally. You know, I've never actually worked in a place where you had to figure out how to get, you know, both patients and staff through mountain passes in the middle of snowstorms. So it's been a lot of fun learning. This is a very resilient community, a very resilient system. Lots of, I mean, a lot of people said, you know, have said to me, like, well, you come from a big system, this must be, you know, must likely be, you know, maybe easier for you or something. You know, it's still a complicated hospital system. You know, it healthcare, hospital care, outpatient care, it's complicated. And so I think, you know, it is a fool's journey not to really start to understand your landscape and take the time to really understand what the problems are, what the challenges are, what the trends are in your region. Because some of them are industry wide, but some of them are very local. So I've been spending my first hundred days really getting to know people, getting to know what they're facing on a daily basis and really understanding this community, which is very different from the community I came from. And it's been a really wonderful journey to take.
- [06:30]
A
So no, I love that perspective and I love the phrase, I've never heard it before. I've always had a jeep but never needed a jeep. That might be my favorite comment of all day. I've never heard that before and I love that. So take a moment, tell us about some of the trends that you're watching in health care now. What are some of the two or three biggest things that you're watching currently?
- [06:55]
B
Yeah, I mean, I'll give you sort of. I have three areas I put my trends into. You know, first is sort of these industry wide trends. And I think, you know, we, we just have to acknowledge that, you know, emerging tech, the rise of tech AI is a really big deal. I mean, I was recently actually at Becker's and everybody was taught, every single talk I went to was about AI. And I think, you know, we certainly are, you know, in the midst of transitions in implementation and a variety of different, across the board, not only in the care sites, but even in the back office sort of work. I think this brings a lot of opportunity, but very much like, like the EHR when we were all implementing EHRs, you know, this will, this requires a lot of change management. So you know, really technology projects are really people projects and we want to ensure that the technology that we're incorporating, that we're implementing is Actually advancing care, not complicating care. So I think, again, you know, you really can't go anywhere now and not sort of be hearing about, you know, digital agents and ambient, you know, AI. And. And so we're. We're in the. On that journey like everyone else. The second area where I'm sort of, you know, where we're a trend I'm kind of watching, and that's very. That's a little bit more local is here in the community. And. And this is really about the transition of Tahoe Forest itself and. And the transition of this region. And. And I would just say that one of the things, and I'm not sure if this data point is actually correct, but an anecdotal thing that I heard, and it does resonate, is that this is one of the number one or in the top zoom towns in America during the pandemic. And I think what. And I think that that sort of stabilized a little bit and leveled back out, and many people have gone back to work, but it did forever sort of change the demographics here in this region. This is a. We're a mountain town, but, you know, fairly local. I mean, fairly accessible to the Bay Area. So I think a lot of Bay Area people moved here during the pandemic and shifted the demographics a little bit. But, you know, that said, we are. We are always. This is a normal sort of phenomenon in this. In this region. We. This the town of Truckee itself, and that's where I'm located. Although we. We, as I told you, serve a much broader region. But let's just use that as an example. There's about 17,000 permanent residents here, but on any kind of given weekend, we can go up to 40,000. And then in the major holidays, like what we're looking at coming up, and now next week with 4th of July or two weeks from now, we will exceed 100,000. And so this is the. And we are the only system in this region. And so we have to, you know, ebb and flow all the time, which is, I think, common in. In. In these destination mountain towns. But I think that, you know, there's just been a lot of shifting in the demographics and lots of people, lots of changes in the last few years. And again, I think that was really spurred, accelerated by the pandemic. But it really, even though it's stabilized it, I think we've kind of emerge from that slightly different town than we were before then. The final thing I'll just say is that this system itself, you know, we started As a hospital district, you know, we consist of two critical access hospitals, very focused, and we still, if you talk to people, they really self identify as a hospital district. But actually we're. We're becoming quite a comprehensive health system. So we have been in. In the midst of this major transition and at, you know, this point now, like 87% of all of our care is outpatient. And an example of, you know, the kind of growth that we're seeing is, you know, in 2017, our system was doing about 70,000 outpatient visits, and in 2024 we did 193,000. And this year we will exceed 200,000. I mean, so just massive growth and sort of massive changes in identity. So those are. Those are all kind happening in the midst of all this other industry stuff, and I'm consciously avoiding kind of what's going on in D.C. but there's a lot of trends there, too. But those are just kind of three examples of how I'm kind of looking at kind of how do you navigate this industry kind of trends, what's going on here, kind of at the community level and then inside the system itself, just a lot of change.
- [11:47]
A
No, 100%. And talk, Anna, a little bit about what you're most focused on and excited about today. And then also, tell me, do you still cheer for the Raiders now that they're in Las Vegas, not in L. A, not in Oakland? How do you look at that? To first, what are you most focused on, excited about? And you still cheer for the Raiders? You still consider yourself part of Raider Nation?
- [12:10]
B
All right, well, I will. You know, what I'm really focused on here is, is what we're really thinking about. And again, I think we are focused on. We're all in the midst of growth. There's so much change. What we really want to make sure we're doing is that we are growing and changing in ways that bring us closer and deeper into the community. And so what I mean by that is, like, what is the single aim of this, of this system? Like, what are we all aiming for? And I think I was just talking to somebody this morning. One of the things that we now can't unknow as health system leaders is, you know, all of us when, when. And I'm using the pandemic one last time here as an example. When we all were faced with having to kind of get, you know, an unprecedented amount of things done, aiming towards a single aim, which was really, you know, save lives and stop the spread, we were able to kind of get out of our own way and, and you know, in a thousand different ways head to the. In the same direction. Very much similar here now is like, what is our single aim? What is that true north that we will take all the different portfolios within our strategy. How will we aim those in a way that sort of is this single overarching aim? And really what will that. How will we articulate that? How will we all have a shared vision towards that? And it. And so we have some work to do around making sure that that single aim, that true north that we're aiming for resonates from sort of the. Those regions, those communities on the lake and, you know, at lake level, as well as, you know, the regions far north that are, you know, very different. You know, how. What is that single sort of aim? So we'll be working on that. And that's one thing we're going to be focusing on. The other thing is really trying to think about how as a leadership system, we can move again. You know, it's a lot about moving closer to the work and making sure that work is aligned with our community. And so really working on very practical things like how do we get out of the conference room and closer to the front line so we can really understand what it is that our leaders and our workers are facing every day? And, and how can we remove barriers so that they can create this extraordinary experience? I mean, I'm very proud that our system is really one of the highest, you know, top performers in patient experience, but we know we can do even better. And so what, as a leadership team, can we do to really continue to ensure that our providers are able to exceed people's expectations and really spend the time that they, they want to and they, and they're trying to with their patients and the people in need. And I, you know, so I think that's what I'm really focused on is figuring out how we can get the system to work for the people we serve and the people who are serving them.
- [15:28]
A
Yeah, just fantastic.
- [15:30]
B
Raider Nation all the way. Sorry.
- [15:33]
A
God bless the Raiders in Art Shell and the entire franchise. God bless Kenny Stabler, Lyle Zado team. God bless. And Fred Bnikov. So many greats from Raider Nation. And I want to thank you for joining us today in the Beckers Healthcare podcast. I can't wait to continue to watch your leadership. I've heard just fantastic, fantastic things about you as a leader and can't wait to watch what continues to happen at Tahoe Forest. Thank you for joining us today.
- [16:00]
B
Thank you so much. I really appreciate it, Sam.