California hospitals claim a move toward performance-based reimbursement under the Affordable Care Act is forcing them to make some hard decisions.
One San Francisco Bay Area medical group is planning to cut more than 200 employees because of financial pressures.
That news doesn't surprise Jan Emerson-Shea of the California Hospital Association. She said hospitals will get billions less from the federal government through Medicare over the next decade.
"I've heard about these things for the last 12 to 18 months, and I expect we will continue to hear about these decisions," Emerson-Shea said.
But Dylan Roby of the UCLA Center for Health Policy Research said a lot of the Medicare payments take into account a hospital's delivery of quality care.
"The federal government didn't just go through and slash Medicare funding just to hit budget targets, they basically replaced a cut with a way to earn the money back," Roby said.
Roby also said the Medicare changes are part of a shift away from payments based on volume of patients.
