周末刚说NIH减indirects对医院会不会有影响,影响就来了。。。。。。。

发帖2024
楼主 (北美华人网)

Mass General Brigham announces largest layoff in its history amid ongoing restructuring Facing rising costs and hoping to make its sprawling network more efficient, the state’s largest private employer aims to cut payroll costs by over $200 million By Jessica Bartlett Globe Staff,Updated February 10, 2025, 2 hours ago
Mass General Brigham's corporate office in Somerville.David L. Ryan/Globe Staff Mass General Brigham said Monday it will let go of hundreds of employees in the next two months, the largest layoff in the organization’s history, as the health system grapples with anticipated financial shortfalls and ongoing operational challenges at its 12 hospitals. With roughly 82,000 employees, MGB is easily the state’s largest private employer. Executives declined to say how many people would be let go, but said the target is to save at least $200 million annually, or approximately 2 percent of its salary and benefits costs. The cuts, which will occur this week and then again in a second round in March, would likely have rolled out more slowly over the course of years as the health system more closely integrates its hospitals, executives said, but have been sped up because of financial pressures. “We are … facing the same unrelenting pressures affecting many health care systems across the country that are contributing to a projected budget gap of a quarter of a billion dollars within the next two years,” Jennifer Street, senior vice president of communications at Mass General Brigham, said in a statement. “We are acting now to allow us to continue with planned and future investments.” Reductions will be focused on administrative and management levels of the sprawling organization, Street said, and will not affect front-line clinical workers or staff that supports patient-facing care. The system will also consolidate some roles and eliminate some vacant positions. “If we do not take definitive action now to stabilize our financial health, we compromise our ability to continue to invest in our mission,” said MGB chief executive Dr. Anne Klibanski, in an email to employees that was obtained by the Globe. The reductions may seem surprising for a health system that has posted positive operating margins each of the last two years, buoyed by a robust investment portfolio. In the 12 months ending in September, the most recent financials that are available, MGB reported a $45 million margin from operations, and a $2 billion net margin, on $20.6 billion in total revenue. Experts looking at the system’s financials said its recent performance points to a level of resilience to face future challenges, at least compared to other Massachusetts hospitals that have less cash and smaller investment portfolios. In that context, said David Rosenbloom, professor emeritus at the Boston University School of Public Health, reductions may have more to do with becoming more efficient than to make up for losses. “They are not currently challenged,” he said. “Are they worried about the future? Yes. When I taught hospital finance, I said the primary and virtually only rule of a hospital is maximize your revenue today because you don’t know what the bastards will do to you tomorrow … There may be (also) inefficiencies of scale, when you get as big as MGB.” MGB executives have put forth a drumbeat of concern about their core operations, saying that much of their operating margin over the last two years has come from federal financial support lingering from COVID or other one-time federal payments, while they face a problematic long-term outlook. They describe a system where costs are steadily rising faster than revenues — which mainly come from private and public insurers who are themselves under pressure to keep health costs in check. And while MGB is able to save some money through improved efficiency, they’ve reached a point where they need to rein in labor costs. At the same time, like many health systems across the state, MGB’s hospitals are crowded, with demand for inpatient beds exacerbating backups that spill over into the emergency room. That has financial consequences too, as hospitals are largely reimbursed once for each discharge, regardless of how long the patient stays in the hospital. So while MGB’s hospitals are busier than ever, its revenue growth has been held in check. One bright spot for the hospital system is the billions of dollars it has seen in investment gains over the past years. But earnings on that money are largely either restricted by donors to certain uses or earmarked to capital projects, such as a $2 billion expansion at Massachusetts General Hospital. It’s not available, they said, to plug financial holes in the core business. The main entrance of Mass General Hospital. Rosenbloom, who several years ago sat on the audit and finance committee of what was then known as Partners HealthCare, said it makes sense why the organization isn’t dipping into its reserves to routinely cover its expenses. But he also noted that was a choice the institution was making with its money, only to invest it into capital projects and not to cover potential future shortfalls. Dr. John Freedman, CEO of Freedman HealthCare, a national health policy consulting firm based in Massachusetts, also pointed at MGB’s cash and investments as a boon to weather what comes next. “Any multi-billion dollar organization has struggles and challenges in running itself,” Freedman said. “The question is, are they somehow worse off than all the other provider organizations in Massachusetts? The answer is a clear no. They are doing much better. They have rich reserves.” Beyond current financial pressures, reductions will also help to achieve efficiencies as part of a long-running effort to better integrate across its system, and in particular across its two flagship institutions — Massachusetts General Hospital and Brigham and Women’s Hospital. That has been underway for sometime, with leadership slowing rethinking jobs and eliminating roles through attrition. Executives acknowledged that the mounting financial challenges accelerated the process, and prompted a wider reorganization plan. In November, executives began having conversations with ultimately over 100 senior leaders across the organization to discuss ways to streamline MGB’s administrative structure. Advertisement Brigham and Women's Hospital.David L. Ryan/Globe Staff Studies of Mass General Brigham’s management structure also revealed that Mass General Brigham had more managers per front-line worker than industry benchmarks, duplicative management roles, and many layers of managers, executives said. While high performing organizations may have maybe seven or eight layers of management between the front line worker and the CEO, in some places at Mass General Brigham, there were 15. “Mass General Brigham is clearly trying to consolidate, become more efficient, cut costs, and dramatically change how it’s organized internally,” said Dr. David Blumenthal, president of the Commonwealth Fund, a national group that does research on health and social policy issues. “Whether it will result in a stronger, more consolidated, premier [academic medical center] remains to be seen. I think it’s a big gamble for this community and we will have to see what the outcome is” There has already been some pushback to MGB’s integration work, especially among doctors. A 2022 plan to bring together large medical services across hospitals stirred anxiety among some clinicians, who worried about being shut out from decision making and increasing corporatization of the system. Then in March 2024, the system announced broader clinical consolidations, merging 34 departments across Mass General and Brigham and Women’s. At the time, executives said they did not expect job cuts. That announcement ignited a firestorm within the workforce, who spoke out in town meetings and voiced ongoing frustration about the changes. Unionizations followed, first at MGB-owned Salem Hospital, and then 300 more primary care physicians employed by Mass General Brigham.
While these layoffs are focused on managers and administrative staff, they could further strain morale. And big healthcare institutions like MGB have encountered fresh challenges in the last few weeks, with threats to everything from federal research dollars to Medicaid funding. On Friday, the National Institutes of Health, which funds much of the country’s basic biomedical research, announced it would slash support for “indirect costs” for research funding — money that hospitals, universities and other research institutions rely on for basic operating expenses. Executives said they did not plan budget cuts in response to possible reductions in federal money, but said creating a healthier organization now builds financial resilience to weather whatever comes next.
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Pangpang
Mass General Brigham said Monday it will let go of hundreds of employees in the next two months, the largest layoff in the organization’s history。
hundreds out of 82,000。“the largest layoff”, 认真的吗?!
N
NeweTowne
Pangpang 发表于 2025-02-10 12:46
Mass General Brigham said Monday it will let go of hundreds of employees in the next two months, the largest layoff in the organization’s history。
hundreds out of 82,000。“the largest layoff”, 认真的吗?!

这只是立即裁的 2个亿要裁很多人
d
danfy
Pangpang 发表于 2025-02-10 12:46
Mass General Brigham said Monday it will let go of hundreds of employees in the next two months, the largest layoff in the organization’s history。
hundreds out of 82,000。“the largest layoff”, 认真的吗?!

很多医院从来没搞过layoff 的。
d
danfy
NeweTowne 发表于 2025-02-10 12:58
这只是立即裁的 2个亿要裁很多人

一个人的package 平均20万的话,才1000个人。1%多一点点。
l
layjohns
虽然但是,医院的budget一般是去年底或者年初讨论通过的,这种大规模消减不可能一个周末就决定了。以后真实施了会有影响,但是这个应该不相干。话说美国大学有时候也是利益优先,科研嘛呵呵,隔壁的州立旗舰去年刚宣布投资2.5亿美元翻修橄榄球场北门,盖大厅和vip区。当时我就想这2.5亿元得可以支持多少科研项目啊。当然了,一个是挣钱挣关注度的,一个短期是赔钱的,呵呵
d
danfy
layjohns 发表于 2025-02-10 13:40
虽然但是,医院的budget一般是去年底或者年初讨论通过的,这种大规模消减不可能一个周末就决定了。以后真实施了会有影响,但是这个应该不相干。话说美国大学有时候也是利益优先,科研嘛呵呵,隔壁的州立旗舰去年刚宣布投资2.5亿美元翻修橄榄球场北门,盖大厅和vip区。当时我就想这2.5亿元得可以支持多少科研项目啊。当然了,一个是挣钱挣关注度的,一个短期是赔钱的,呵呵

橄榄球关系到电视转播分成和校友捐款,比整个graduate schoo加起来都重要,毕竟美国大学可以没有graduate school, 不能没有橄榄球队。
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layjohns
danfy 发表于 2025-02-10 13:45
橄榄球关系到电视转播分成和校友捐款,比整个graduate schoo加起来都重要,毕竟美国大学可以没有graduate school, 不能没有橄榄球队。

也是,看了好几次现场,只要暂停或者休息,就是各种捐款人物单位或者表彰先进的粉墨登场,合影招手,校长和个人形立牌一样
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dodgers
回复 6楼 layjohns 的帖子
这是consumer demand要football.
6,70年代,美国科研经费没有现在多。faculty日子比现在好很多。
如果经费削减,学校减少培养博士,博士supply大量下降。faculty市场会转好。不见得是坏事。
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luoyuwei
"the state’s largest private employer", 私立医院也拿NIH很多钱了吗?
B
Baguette
layjohns 发表于 2025-02-10 13:40
虽然但是,医院的budget一般是去年底或者年初讨论通过的,这种大规模消减不可能一个周末就决定了。以后真实施了会有影响,但是这个应该不相干。话说美国大学有时候也是利益优先,科研嘛呵呵,隔壁的州立旗舰去年刚宣布投资2.5亿美元翻修橄榄球场北门,盖大厅和vip区。当时我就想这2.5亿元得可以支持多少科研项目啊。当然了,一个是挣钱挣关注度的,一个短期是赔钱的,呵呵

他们在研究budget的时候肯定考虑到川普上台会砍funding这个问题了。学校里的教授们每到选举季最关心这个
B
Baguette
danfy 发表于 2025-02-10 13:45
橄榄球关系到电视转播分成和校友捐款,比整个graduate schoo加起来都重要,毕竟美国大学可以没有graduate school, 不能没有橄榄球队。

因为球队也是创收项目啊,虽然花很多钱但回来更多钱
找密码2025
是的,有人不理解,其实政府也是一个创造就业的部门。 给两百万联邦雇员发劝退信,从政治上看他们极端派夺权要burn down整个政府系统是一方面,另一方面这也是制造了大量失业,不仅仅是直接的联邦雇员,还有相关各种服务业
E
Emilia
Cleveland clinic 也在裁人,主要是admin,这是在NIH公告之前。operation cost too high
d
danfy
luoyuwei 发表于 2025-02-10 13:57
"the state’s largest private employer", 私立医院也拿NIH很多钱了吗?

如果做很多research, yes.
发帖2024
layjohns 发表于 2025-02-10 13:47
也是,看了好几次现场,只要暂停或者休息,就是各种捐款人物单位或者表彰先进的粉墨登场,合影招手,校长和个人形立牌一样

说实话,建球场这些还有一个positive agenda——Mass General Brigham前两年改名字,从“partners"改到"MGB",branding花了整整一个亿(没数错0, 就是100 million)。。。。。。。
还听说过一个真事儿,说之前Partners请了顶级consulting firm,给自己的Biobank换名字。大几十万花掉之后,consulting firm confirmed “还是Partners最好!”
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Irisblue19
我们医院已经把休息室的零食饮料砍了,真是从牙缝里省钱。
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Daylight
danfy 发表于 2025-02-10 13:45
橄榄球关系到电视转播分成和校友捐款,比整个graduate schoo加起来都重要,毕竟美国大学可以没有graduate school, 不能没有橄榄球队。

其实挺好的。以前用爱发现,现在用橄榄球发电
吃鸡蛋
裁的都是行政的
过去20年,美国医院行政和医务人员数量比翻了好几倍,该瘦身了
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Dongjie
mayo,约翰霍普金斯也开始裁人了。没病的人赶紧祈求自己不长病,有病的只好自求多福吧。
吃鸡蛋
回复 20楼 Dongjie 的帖子
裁的基本是行政的,这些人对patient care 是负资产,尽给医护找麻烦显示存在感
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danfy
Dongjie 发表于 2025-02-10 19:16
mayo,约翰霍普金斯也开始裁人了。没病的人赶紧祈求自己不长病,有病的只好自求多福吧。

和病人没关系。护士医生现在缺的厉害,Mass General Brigham现在就有800个护士的job可以申请。
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Dongjie
吃鸡蛋 发表于 2025-02-10 19:19
回复 20楼 Dongjie 的帖子
裁的基本是行政的,这些人对patient care 是负资产,尽给医护找麻烦显示存在感

那是你的美好愿望吧,事实是医院里一个萝卜一个坑,一个闲人都没有。那一点环节drop the ball,都会有医疗事故。
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lastunas
行政人员太多了,工资高不干啥正经事
b
boxwood
这个应该是早就决定了的。不是因为这几天的新闻了。
a
akebaby
danfy 发表于 2025-02-10 13:45
橄榄球关系到电视转播分成和校友捐款,比整个graduate schoo加起来都重要,毕竟美国大学可以没有graduate school, 不能没有橄榄球队。

牛橄榄球队的教练都是几个米一年的薪水,那都是学校的cash cow,比校长还牛逼
h
hq50
回复 17楼 Irisblue19 的帖子
我们早没了
y
yunhao
danfy 发表于 2025-02-10 13:35
一个人的package 平均20万的话,才1000个人。1%多一点点。

真是何不食肉糜,或者就是川粉一贯昧着良心说话。很多普通岗位的护士和管理人员也就几万的工资而已
A
AlaskaNYC
吃鸡蛋 发表于 2025-02-10 19:03
裁的都是行政的
过去20年,美国医院行政和医务人员数量比翻了好几倍,该瘦身了

正解。 过去20年行政人员比医护人员增长多十倍, 这就是美国医疗费用多的一个大原因,
A
AlaskaNYC
Dongjie 发表于 2025-02-10 19:34
那是你的美好愿望吧,事实是医院里一个萝卜一个坑,一个闲人都没有。那一点环节drop the ball,都会有医疗事故。

一个闲人都没有, 哈哈哈哈
X
Xiaojiao
反正各行各业都在裁员,没人例外也算公平
p
poopooh
影响是立竿见影的。因为预算的时候是考虑了NIH founding 的。结果没了,必须马上砍,否则立马钱就不够了。
s
stone1999
医护虽然缺,医院想省钱的时候还是会裁医护岗,没见过裁行政岗,这些年下来,眼见着一个护士要管的病人越来越多,行政那边一个岗位都没少,有权利做决定的人怎么会砍自己和自己的助手呢
d
dudu@NY
跟nih没关系。医院不是靠NiH的funding的。明白hospital finance,好好读了原文,就知道跟标题无关。
冷月凝香
我村最大的医院系统裁员从去年下半年就开始了,目前裁的基本上都是行政,clinical相关员工不受影响。
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danfy
yunhao 发表于 2025-02-10 20:10
真是何不食肉糜,或者就是川粉一贯昧着良心说话。很多普通岗位的护士和管理人员也就几万的工资而已

又不会裁护士。医院管理人员一年工资10万比较普遍,乱七八糟的一加,医院成本就要20万了。
找密码2025
刚刚看到新闻,阿拉巴马参议院跳脚急了,因为他们州几乎最大的employer 就是阿拉巴马大学,大量雇员靠这个nih,川普的铁拳下来,他们这样的红州最惨,真是求锤得锤,自作孽不可活
U
Uturn
美国医院这些所谓的行政管理,臃肿浮夸,腐败无比,到处裙带关系,胡乱伸手医务工作,不懂装懂,令人不齿。这些垃圾MBA 绝对是毁了美国医疗系统的推手。
好不容易碰到几个应手的护士技师,很快就被他们正走了,说到这些垃圾MBA 我就火大😡
p
poopooh
找密码2025 发表于 2025-02-10 23:34
刚刚看到新闻,阿拉巴马参议院跳脚急了,因为他们州几乎最大的employer 就是阿拉巴马大学,大量雇员靠这个nih,川普的铁拳下来,他们这样的红州最惨,真是求锤得锤,自作孽不可活

阿拉巴马需要个屁的大学。他们这种稀特厚州根本不配有学校。
找密码2025
回复 1楼 的帖子


不好意思,我吃瓜一下 看看原来跪舔川普的共和党议员现在什么样的表情



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