Photos: Reworking healthcare in Las Vegas

Steve Bonzheim, second from left, waits for medical care with his wife, Kathy, as another patient arrives in the often overcrowded emergency room at University Medical Center in Las Vegas.

(Christina House / For The Times)

June 6, 2014 2:28 PM PT

When Nevada decided to guarantee state residents health insurance under the Affordable Care Act, a handful of doctors and civic leaders in Las Vegas began working to remake the way patients are cared for by adopting models of care pioneered in America’s healthiest communities.

Last year, state regulators exposed hundreds of cases in which private Nevada hospitals dumped uninsured and Medicaid patients onto the public University Medical Center. (Christina House / For The Times)

Melissa Warner, from left, Jasmine Wheeler and Lupe Patino sit in the waiting area of the University Medical Center’s ER. (Christina House / For The Times)

Dr. Dale Carrison is chief of staff at University Medical Center, where the waiting room fills daily with the city’s uninsured, its poor, its mentally ill, its homeless and its immigrants. (Christina House / For The Times)

Crunched for space, University Medical Center’s emergency room runs an improvised kidney dialysis center for immigrants who are in the country illegally.

(Christina House / For The Times)

Dr. Dale Carrison sees patient Wilfredo Pizarro at University Medical Center. Before Nevada expanded its Medicaid program, nearly 30% of working-age adults in greater Las Vegas lacked insurance. (Christina House / For The Times)

Jose Hernandez, 50, who works in housekeeping at a hotel on the Las Vegas strip, sits in the waiting room at the Culinary Extra Clinic, where staff have turned the traditional doctor’s practice on its head, delivering highly personal primary care instead of quickly churning patients. (Christina House / For The Times)

Culinary Extra Clinic staff members, including Chidimma Ozor, center, attend their morning huddle, a daily meeting to discuss which patients need more intervention. (Christina House / For The Times)

Rosa Segovia, 59, is seen by health coach Veronica Jaime, left, and Dr. Eva Snow at the Culinary Extra Clinic. (Christina House / For The Times)

Jackwood Wu, a cook at a hotel restaurant on the Las Vegas strip, visits with his health coach Chidimma Ozor at the Culinary Extra Clinic. Many discussions here focus on how patients can change the way they eat, exercise more or take other steps to improve their health. (Christina House / For The Times)