Florida hospital group shuts primary care centers

Two primary care clinics will close as part of 93 layoffs announced Nov. 11 by the Jackson Health System in Miami.

The closures and layoffs, scheduled to occur in January 2010, come as the county-run hospital system has tried to cut a $168 million budget shortfall. The system previously was able to cut $61.7 million. But it said it also needs to close the primary care clinics, as well as a liver transplant unit, a heart-and-lung transplant unit, a wound care unit and a mental health unit.

Attempts to convert the primary care clinics into federally qualified health centers were not successful, according to Jackson officials.

The system did not disclose if any doctors would be laid off. Jackson Health uses a combination of doctors affiliated with the University of Miami Miller School of Medicine as well as its own employed physicians.

Jackson began hiring its own doctors and expanding its services several years ago when the University of Miami, which had used Jackson Memorial Hospital as its teaching facility, considered getting its own facility. In 2007 the university bought Cedars Medical Center, across the street from Jackson.

While University of Miami doctors continued to work at Jackson, tensions between the two sides began running higher, culminating in a Nov. 2 summit in which school officials criticized the quality of doctors that Jackson was hiring and the hospital system's expansion strategy.

Meanwhile, Jackson leaders accused the university of sending private insurance patients to Cedars and the poor and uninsured to Jackson.

The Jackson system is funded by property and sales taxes, both of which, the hospital said, have dropped considerably over the past few years because of the economic recession and the rapid drop in the area's land values. The recession also has brought increased demand from uninsured patients.

Closing the clinic and other units will not be enough to fill the rest of the budget gap, so hospital executives are still looking for more areas to cut.

The employee cutbacks were announced in a year that already has seen a large number of mass layoffs at hospitals. As of Sept. 30, the Bureau of Labor Statistics said there had been 127 layoffs involving 50 or more employees. That already exceeds the 112 mass layoffs for all of 2008, and nearly double the 67 for 2007.