In an earlier post, I laid out data I have been accumulating from press reports on job layoffs in the health care sector, mostly affecting hospitals and health systems.  Today (6/27), 60 more layoffs were announced in Springfield (MO) by Ozarks Community Hospital.  

Thus I am updating the table I presented earlier (attached here), which shows almost 1,000 jobs affected in Missouri 
(including layoffs, jobs eliminated that are vacant but will not be refilled, and jobs where hours will be reduced) since April 2013.  As I noted earlier, this number is indeed an estimate, especially since this is based only on press reports I can find and these often do not give many details (for good reasons).

As I earlier noted, it is difficult attribute these layoffs all to one cause, though the CEO of Springfield Hospital does attribute the layoffs to the lack of a Medicaid expansion in Missouri.  As I noted in my earlier post, hospitals and health systems are facing many challenges and reductions in payment streams.  These would be mitigated 
by a big increase in revenues that would come from new enrollment from the Affordable Care Act (ACA), however in Missouri our state chose not expand Medicaid and fiercely resisted implementing the Marketplaces, so we have a very slow growth in the number of insured persons.  This means hospitals and health systems face very dark clouds, especially when they see cutbacks in "disproportionate share" (DSH) payments coming soon. What would be their response?  A logical response would be to make layoffs, I would expect, or that is my supposition.

I continue to find this a very worrisome trend, especially if the state continues to resist expanding Medicaid and fights implementation of the ACA.  Also the Governor recently announced that the state faces a revenue shortfalls due to a sluggish economy; thus Missouri is not growing as fast as other states.  Certainly if the trends in job layoffs continue this cannot help.