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N.H. Hospital Lays Off 18

Nashua — Eighteen people lost their jobs at St. Joseph Hospital on Monday, a reflection, said the hospital, of moves to shift health care out from behind hospital walls.

“We’re doing a better job of keeping people out of the hospital, with fewer in-patients,” said Melissa Sears, vice president of strategy and business development for St. Joseph. “Overall, the amount of health care that we deliver, the health-care system delivers, isn’t necessarily going to decrease, but where we’re delivering it is changing.”

“We are matching staffing patterns to volume of patients that we’re seeing,” she said.

Sears said 54 positions were eliminated, but only a few of them were occupied, by a total of 18 individuals, some of whom were part-time. They include RNs and licensed nurse assistants, as well as people in the business back office, Sears said.

One of the major goals of health-care reform is to have fewer patients treated in hospitals, which tends to be expensive, in favor of having them treated at home or in out-patient settings such as doctors’ offices or “immediate care” and “urgent care” practices that have fewer facilities than hospitals and often aren’t open 24/7, and thus have lower overhead costs. These facilities are often owned by hospitals or holding companies that own hospitals.

Sears noted, as an example, the hospital’s creation of “care coordination” jobs, whose role is to oversee the care of patients with on-going problems, such as diabetes, so that they don’t have to come to the hospital.

“Patient-centered medical practice is starting to work as intended. Better management for patients with chronic conditions, means fewer hospital visits,” Sears said.

Sears said St. Joseph Hospital had no plans to cut back on its 208 beds, noting that communities need a certain number of beds for a possible “surge” in medical needs, such as “a fairly robust flu season.”

The layoffs also reflect the fact that no matter what changes are made, cutting health-care costs often requires laying off people, because labor costs make up a large portion of health-care spending.