Michael McGarry, Chair of the Board of Directors at Tahoe Forest Health System

Summary

Becker’s Healthcare Podcast Summary: Michael McGarry on Tahoe Forest Health System and Healthcare Innovation

Introduction

In the July 27, 2025 episode of the Becker’s Healthcare Podcast, host Scott Becker engages in an insightful conversation with Michael McGarry, Chair of the Board of Directors at Tahoe Forest Health System. The discussion delves into McGarry’s extensive career in healthcare, the unique dynamics of managing a rural yet affluent health system in a resort area, challenges related to housing for healthcare staff, emerging trends in the healthcare industry, and his advice for aspiring healthcare leaders.

Michael McGarry’s Background and Tahoe Forest Health System

Michael McGarry brings nearly three decades of experience in the healthcare industry, blending engineering expertise with a deep commitment to health systems innovation. He explains, “My background's in engineering and so I spent a lot of time on the industry side, new product development, clinical studies, FDA and regulatory” (00:38).

Tahoe Forest Health System serves the Truckee, California area and extends into Nevada, offering a unique blend of rural and resort healthcare. McGarry describes the system as “resort healthcare,” highlighting its advantageous payer mix and affluent community, which includes many million-dollar homes and seasonal residents. This unique positioning provides a degree of insulation from common challenges faced by other rural health systems, though it's not entirely immune to them.

Housing Challenges in Resort Communities

A significant topic discussed is the difficulty of providing adequate housing for healthcare staff in resort towns. McGarry emphasizes, “we offer housing assistance as part of our physician recruitment programs... the cost of living is remarkably high here, median home price is north of a million dollars” (04:40). The scarcity of affordable housing necessitates creative solutions, such as staffing some departments in more affordable nearby areas like Reno, Nevada, which lies about 30 miles away.

Emerging Trends in Healthcare

McGarry identifies several critical trends impacting healthcare systems today:

1. Administrative Changes: The rapid pace of policy and administrative decisions, particularly under the current administration, keeps health systems agile and responsive.

2. Housing and Staffing: Continues to be a central concern, as highlighted earlier.

3. Clinician Burnout and Rising Costs: Increasing operational costs, including supply costs rising by 10-15% annually, while margins tighten.

4. Collaborative Efforts Among Health Systems: McGarry is particularly excited about the growing willingness among health systems to collaborate, a trend accelerated by the COVID-19 pandemic. He notes, “health systems were forced to collaborate in ways and at a pace that we never had before” (06:07).

5. Community Engagement: A forward-thinking approach where health systems actively engage with their communities to promote health beyond treating illness and injury. McGarry states, “we have a critical role... understanding the needs of a community and how we best support them every day” (07:50).

Michael McGarry’s Career and Passion for Healthcare

McGarry’s fascination with healthcare stems from his undergraduate studies in biomedical engineering, where he was captivated by the complexity and resilience of the human body. “I was just amazed at the human body... it's a remarkable piece of machinery” (09:08). Although he initially considered medical school, he chose to pursue engineering within the healthcare industry, working on medical devices like pacemakers and stents before shifting focus to health systems innovation.

Over time, McGarry recognized the importance of preventive care and community health, leading to his role at Tahoe Forest. He emphasizes the balance between technological advancements and supporting the community’s everyday health needs.

Current Focus and Leadership at Tahoe Forest Health System

This year marks a period of significant transition for Tahoe Forest Health System. After a leadership change involving the departure of the former CEO, McGarry describes the admission of Anna Roth as the new CEO and subsequent leadership shifts aimed at fostering creativity and extraordinary thinking. “We're truly excited about the future we have in front of us... through leadership and the lens of leadership” (11:10).

The focus is on moving beyond financial stability to embrace a more holistic role in community health, including philanthropy and innovative partnerships.

Advice for Emerging Healthcare Leaders

McGarry offers compelling advice for aspiring leaders in the healthcare sector:

• Think Beyond Current Constraints: “Never take no for an answer. If you believe something is right for the community... challenge it” (13:10).

• Embrace Creativity and Innovation: Encourage leaders to “color outside the lines” and envision what healthcare could be, not just what it is.

• Advocate for Change: Utilize platforms like lobbying and engaging with governing bodies to drive systemic improvements.

Notable Quotes

• “We really fall in a category that I call resort healthcare... allows us to operate and think a little bit differently” (00:38).

• “We're seeing a trend towards health systems rethinking their position in the community” (06:07).

• “Never take no for an answer. If you believe something is right for the community... challenge it” (13:10).

Conclusion

Michael McGarry’s leadership at Tahoe Forest Health System exemplifies a forward-thinking approach that balances operational excellence with deep community engagement. His insights into the challenges of healthcare in resort areas, the importance of collaboration, and the need for innovative leadership offer valuable lessons for the industry. As Tahoe Forest navigates its evolving role, McGarry’s vision underscores the critical intersection of healthcare delivery and community well-being.

Timestamp Reference

• 00:38
• 04:40
• 06:07
• 07:50
• 09:08
• 11:10
• 13:10

Transcript

[A]

This is Scott Becker with the Becker Healthcare Podcast. I'm thrilled today to be joined by a brilliant person. We're joined Today by Michael McGarry. Michael serves as the chairman of the board, the Tahoe Forest Healthcare District in Truckee, California or in Tahoe. He'll tell us more. And more specifically, he also is involved with MATTER and you'll tell us about that as well. MATTER is one of the brilliant healthcare accelerators in the country and fascinating. Michael, can you take a moment and tell us a little bit about your background and about Tahoe Forest?

[B]

Yeah, absolutely. Scott, again, thanks for the invite to join you today and looking forward to the conversation. You know, I've been in, in the healthcare industry for a little over 25 years. Coming up on almost 30 years and I've really lived in both worlds. My background's in engineering and so I spent a lot of time on the industry side, new product development, clinical studies, FDA and regulatory. But I've also spent a lot of time on the health systems side, more in the role of innovation. Right. How do we, how do we support health systems in adopting and deploying new solutions? And my work with Tahoe Forest is so, you know, my day job with MATTER is really in that capacity. And then my, my work with Tahoe Forest is simply where we chose to live. You know, Lake Tahoe and the Truckee area is a phenomenal place to live. We've been up here for about 20 years and I wanted to be really connected to the local health system and so joined the board about four and a half years ago. Tahoe Forest is a non for profit rural healthcare provider. We're serving communities in Truckee, North Lake Tahoe and surrounding areas in California, Nevada. So kind of unique for a smaller health system. We operate across two states just because of where Lake Tahoe sits. And while I think under, you know, most classifications we would be considered rural health care, I actually classify us. I don't know if I coined this or it's probably out there, I'm sure, but we really fall in a category that I call resort healthcare. So because of things like, you know, volume, there are certain service lines, it'll just never make sense. But we do have unique opportunities. We have a fairly healthy community. Again, a lot of people self select to live here because of the wonderful outdoor activities. We also have a phenomenal payer mix and we have a lot of $10 million homes in the neighborhood, a lot of people that have second and third homes. And so we're really fortunate where we sit in the community we serve that allows us to operate and think a little bit differently. When you think of all of our rural health systems nowadays, many of them at risk of closure for any number of reasons, you know, we, we seem to be a little bit insulated. I wouldn't say we're, you know, we're 100% protected, but a little bit insulated from some of the main challenges that.

[A]

Rural health systems have.100% in the Tahoe Forest Health system is a great, great house. I've been familiar with it for a long time. I'm going to ask you two or three questions, Michael, and you have to let me know if you are mentally and spiritually prepared for these questions.

[B]

Let me know 100%. I love the way that you woven you spiritually because some of this work we're doing, it take more than just your brain, that's for sure.

[A]

Well, Michael, thank you for telling us about the tile Forest health system and, and, and my goodness, fantastic. The work that matter does and what an amazing career you had. The first question I may ask you is there is a recent host of a podcast that that's under sort of the health economics area, the scientist.com company and you may enjoy our podcast, but I assume that this is your favorite podcast and podcaster and for 100 hours, who is the podcaster that we are talking about, Michael?

[B]

Ooh, I think I'm gonna have to go with Paige McGarry on that one. We do share a last name and for 21 years we shared a household as well. Yes, very proud of my young page.

[A]

There you go. Congratulations. You nailed that answer. Congratulations. Fantastic. Paige McGarry, host of a podcast on the podcast series or healtheconomics.com the next question I have for you, Michael, and this is something that goes closer to the heart of Tahoe Forest. One of the issues people are thinking about, and I wonder how much time you folks have to think about it there. When health systems are in resort towns, they sometimes run this in challenge of housing for their teammates, housing for their team members. How much time do you folks have to spend on that issue there to make sure there's appropriate housing? Is there enough housing for people? What does that look like?

[B]

Yeah, it's a great question, Scott. And it's front and center for us. And again, probably uncommon for a health system of our size to offer housing assistance as part of our physician recruitment programs. Not only is the cost of living remarkably high here, I think your median home price is north of a million dollars, $1.1 million. There's also just a shortage of housing. Simply housing houses may not be available for a lot of our staff. Thankfully, we can take advantage of, you know, a lot of the remote opportunities. We've got a lot of team members staffed down In Reno, about 30 miles, you know, down the road. A lot more housing options down there. So a lot of our. For example, our finance department has a number of offices down there. And again, because we operate in both Nevada and California, you know, we can get creative with it. But it's a huge challenge, and not only for our staff, but, but for those who choose to live here.

[A]

100% people that are recruited there, physicians, everybody. I assume that it becomes a challenge for. To be able to build and grow the way you want to. We hear it so commonly, particularly about sometimes what you think of as resort communities, Cape Cod, other places, just the housing is. It can be really challenging. I assume the same in the Aspens, the veils of the world and other places. And what are some of the. Michael, you joined the board four years ago. You've had this magnificent career. What are some of the trends that you're watching most closely currently? What's, what's top of mind?

[B]

You know, it's hard to. Hard to answer that question right now with anything but what the administration's doing, you know, clearly top of mind as best we can, keeping up with everything, you know, day by day. The whiplash pace at which decisions are being made, though, you know, keeps it. Keeps it entertaining, let's say. But beyond that, you already mentioned housing as a key challenge for us staffing. You know, these are common themes we're seeing. You know, I work through my, my work with matter. I'm engaged with health systems all over the country. You know, these are. These are themes that we're seeing everywhere. Clinician burnout, obviously, the rising cost of care, be that related to tariffs or not. I think we were seeing supply costs, you know, going up 10, 15% year over year, you know, margins tightening up, you know, so we, we're not immune to any of those. But when we think about the trends, that. One that I'm most excited about is health systems willingness to collaborate. And I think Covid for as many challenges that it introduced to us as a country. I think there was a silver lining there. And health systems were forced to collaborate in ways and at a pace that we never had before. And I see a lot of willingness. The other health systems that are around the Lake Tahoe region, you know, we opened up lines of communication out of necessity. You know, hey, do you have any masks? We're out, you know, and we've maintained those lines of communication and we're collaborating in ways that we never have before and really focusing on what's best for the community and what's best for the patient. And I know that's always been front and center in healthcare, but going back to the. The theme of health economics, you know, it's a business first and foremost, and, you know, we always keep a close eye on the budget and, you know, how we're performing financially. But we're seeing a trend towards health systems rethinking their position in the community. Right. What does it mean when we extend our creativity and our thinking to go beyond just injury and illness care and start to think about what it means to engage our community in health every day? And that's something that we're really excited about. We're in the infancy of thinking here the last year or two, but it's a direction that we're taking very seriously and feel that we have again as a health district as well. So we actually receive tax dollars from the community to support the health system. We have a critical role, we believe, in going beyond just delivering the care that we get reimbursed for, so to speak, and really understanding the needs of a community and how we best support them every day in health as much as in illness and injury.

[A]

Thank you very, very much. And, Michael, take. Take a moment and tell us a bit about how you came to have such an interest in health care. If you don't mind, take us back a little bit to your interest in health care and maybe a little bit about your career, because it's been a crazily successful career. Tell the audience a little bit about you.

[B]

Yeah, it goes back probably the early days, and it's, you know, my undergrad was in biomedical engineering, and I. I really was just amazed at the human body. And again, through the lens of an engineer, how we could repair the human body, how we can manipulate the human body, the fact that the human body works every day just would blow my mind. Like, when you think of the complexity of all the things that have to happen for something as simple as just walking, you know, things we take for granted, all the different, you know, muscles that have to fire and the neurons that have to fire just to make walking possible. It's really, really a remarkable piece of machinery. Not, not to belittle the human body to a piece of machinery, but, you know, so my fascination was with that and how do we optimize that how do we optimize the performance and optimize functional fitness, you know, as, as a person? And, you know, my earliest days was really that just a fascination with, with the human body. I dabbled with med school for a little bit up through and taking the MCATs and applying and decided that wasn't the path for me. And so I pursued the engineering side of it in the industry. And, you know, the first third of my career was really in class three. Medical devices, pacemakers, stents, catheters that, you know, those sorts of things. And, you know, I've just kind of built on that. And over time, what really led to me, to some of the comments I just made about Tahoe Forest is while it's remarkable what we can do from an engineering standpoint, we also have a remarkable ability to care for ourselves and to heal just through the choices we make every day. The food we eat, sleep, stress are critically important. And understanding the role of the health system and supporting the community in those things is really where I've evolved through the years, is understanding how we, how we engage in a more collaborative way with our community and support them 100%.

[A]

And Michael, talk a little bit about what are you most focused on and excited about this year?

[B]

So this year we, you know, as part of this transition from, you know, and I want to be really clear, the Tahoe Forest phenomenal health system, you know, state leading patient satisfaction, running positive margins year over year, our former CEO really did a phenomenal job from an operational standpoint, really, really building an incredible health system. And we, over the last two years have gone through a leadership change. We parted ways with our former CEO, which was a long journey. You know, leadership critically important, and especially on paper when everything looks to be going well, you know, as I said, patient satisfaction and quality scores and finances all look phenomenal. What we felt we were missing, though, was the leadership to carry us into this new future, right? To go beyond the balance sheet, to go beyond the finances, the health system, and really embrace our role in caring for the community, sometimes in ways that we may not be reimbursed for. So how do we get creative with philanthropy and with different partnerships in the community? And so really excited as we look at. So Anna Roth, our CEO, she joined just over two months ago, so we're fresh in that transition and we've made a few other leadership changes, more in the psyche of the leadership, right? Not actual personnel and people coming and going from the health system, but really encouraging them to think beyond the ordinary and really challenge them. To think about what does it mean to be extraordinary. And I'm just wildly excited about the future we have in front of us. But it's really all through leadership and the lens of leadership and having the right team in place to carry you forward into an unknown future. And I say that without fear. To me, that's exciting, this unknown future.

[A]

It really is really amazing. Take a second, Michael. And what advice would you give to emerging leaders? What would you tell an emerging leader?

[B]

Yeah, I think the first thing, especially in healthcare. I've been fortunate to have exposure to a number of other industries and leadership within healthcare, I think gets conditioned to limit their thinking to how things are done. What do we get reimbursed for? What is the protocol call for clinical workflows? It's a really structured world and should be in many ways, don't get me wrong, you know, there's tremendous benefit in that. But I think there's also a time where you have to color outside the little, outside the lines a little bit. Right. And not be limited by how things are today and think about what they could be tomorrow and embrace a culture of yes. You know, it's so easy to fall back on and again, oftentimes for very real reasons. You know, it's easy to say no, know, oh no, we can't do that, we can't afford that. That's not in the budget. You know, cms, you know, guidelines limit us. And by no means am I advocating, you know, going against the law here, but you know, these are all human created systems, you know, so we can go and we can lobby government and we can go to the FDA and we can go, you know, to all the various governing organizations and, and we can make change. And so I guess my advice to the, you know, the, the, the existing and upcoming leaders is just never take no for an answer. If you believe something is right for the community, is right for your patients, but it doesn't fit within the current structure, challenge it. Get creative, Think about how you can get to yes and not be satisfied with a no.

[A]

No. I love that, that voice, that thought, that obsession with trying to get to greatness, not just to let it be and play within the lines. I just love that, Michael, what an amazing career you've had. I love the Tahoe Forest Health system. Congratulations on the leadership evolution there. Thank you for joining us on the Beckers healthcare podcast. And congratulations most importantly to Paige McGarry on her podcast.

[B]

Congratulations and Scott, appreciate the shout out for her. She'll be, she'll be tickled pink to get some free pr.

[A]

God bless. Thank you so much for joining us today, Scott.

[B]

Appreciate it. Thank you.

[A]

Sam.