Miami's Mt. Sinai Medical Center has announced plans to lay off an undetermined number of employees in the wake of continuing losses. BBA also placed a limit on the number of residents for which hospitals would be compensated. Institutions will be restricted to the same IRB that they had on Dec. 31 of the preceding year. A reduction in beds would necessitate a corresponding reduction in interns and residents to stay within the cap. Hospitals also will be offered incentive payments over five years to reduce the number of residents they train.
Academic leaders disagree.
At least 47 of these hospitals could face negative operating margins by 2002 or sooner. The AAMC says COTH hospitals provide a wide range of services that are not reflected in the direct or indirect costs of medical education. Harry Jacobson, M.D., asked rhetorically in a press statement. Now Medicare payments are rising more slowly so the pressure is on because managed care is continuing to demand discounts and hospitals are having a more difficult time meeting those demands. What the COTH hospitals do is include all sources of payments.