The once "recession-proof" healthcare industry continues to struggle, with many hospitals laying off workers, health systems enduring investment losses, and states seeing their Medicaid rolls grow. Legislators at both the national and state levels appear to be serious about reform. However, let's hope that reform means real quality and efficiency improvements to the delivery system, and not simply throwing more money into the existing system.

Here's a quick look at what happened this week in local communities around the United States:

CALIFORNIA
Watsonville Community Hospital in Watsonville, Calif., laid off 39 workers this week in a move designed to cut costs. Officials said the layoffs are the result of an analysis that showed the hospital could restructure to operate more effectively and efficiently. The layoffs represent about 5 percent of the hospital's nearly 700 full-time and part-time employees.

COLORADO
More Coloradans are covered by Medicaid than at anytime in the program's 40-year history, according to the Colorado Department of Health Care Policy and Financing. The number of Colorado residents receiving Medicaid benefits rose to 457,699 in April – an increase of more than 9,000 from the previous month and 72,597 from the same time last year. John Bartholomew, chief financial officer for the department, said the rise is directly related to economic conditions and efforts from the department to increase the number of Coloradans with health insurance.

CONNECTICUT
The Connecticut state House of Representatives voted this week for a landmark bill aimed at achieving universal healthcare in the state by creating a public insurance pool that anyone could join, regardless of health history. The pool would be based on the existing pool for state employees, and is designed to compete with private insurance plans. The state Senate has not yet acted on the bill, and Gov. Jodi Rell (R) could ultimately veto it.

FLORIDA
Baptist Health South Florida lost $24.8 million on operating revenue of $530.2 million in its second quarter. That is an improvement from a loss of $26.8 million on operating revenues of $470.2 million in the same quarter of 2008. However, the Miami-based health system provided $63.5 million in charity care and registered $81.1 million in bad debt in the second quarter. In the same period last year, those expenses were $46.5 million and $65.9 million, respectively.

MAINE
State budget negotiations have stalled and the Maine Department of Health and Human Services sent out a notice indicating that it has run of money to pay MaineCare providers. This means that many healthcare providers won't be able to meet payroll and may have to stop providing critical services to seniors, people with disabilities, and low-income families with children.

MINNESOTA
North Memorial Health Care in Robbinsdale, Minn., is cutting 100 positions, or about 2 percent of the hospital's workforce. A combination of reduced hours and layoffs will affect 170 employees. This is the second round of cuts in six months at North Memorial. In December, the hospital eliminated 380 jobs, or 7 percent of its workforce. Reduced patient volumes and an increase in charity care and bad debt have forced the hospital to take action. North Memorial has absorbed $17.5 million in bad debt, charity care and discounts for the uninsured so far this year.

TEXAS
Savills, the international real estate advisor, has arranged a joint venture capitalization on behalf of Duke Realty Corporation for a new, 460,000-square-foot Baylor Cancer Center that will be developed by Duke on the campus of Baylor University Medical Center in Dallas. The transaction is valued at $154 million. Savills's Healthcare Real Estate practice represented Duke in securing Northwestern Mutual as Duke's partner in the 100 percent equity transaction. Northwestern will hold a majority interest in the joint venture. The 10-story outpatient cancer facility and medical office building's two primary tenants will be Baylor University Medical Center and US Oncology, an oncology services company. Construction is scheduled to begin during the second quarter of 2009.

The Texas House and Senate have passed separate versions of legislation to allow families that earn too much for SCHIP coverage to buy into the program. Each of the versions passed by the House and Senate would expand the SCHIP program to include families earning up to 300 percent of federal poverty levels, about $66,000 for a couple and two children. Currently, Texas families earning up to 200 percent of the federal poverty level, or about $44,000 for a family of four, are eligible for CHIP. Differences in the bills need to be resolved in the next two weeks before the legislative session ends.

WYOMING
Wyoming has received a Governor's Health Professional Shortage Area (HPSA) designation for additional regions of the state from the federal government, which should lead to higher Medicare and Medicaid reimbursements in those areas. HPSAs are counties, partial counties or communities that, by federal definition, have too few primary care providers for the populations they serve. The HPSA approval makes it easier for certain areas of Wyoming to qualify for federal Rural Health Clinic status.