Healthcare organizations, and hospitals in particular, are trying to cope with a tsunami of financial challenges as the industry undergoes transformational changes brought on by the Patient Protection & Affordable Care Act. Cuts in Medicaid and Medicare reimbursements have hurt revenue, which has been further reduced by the federal sequester and lower state funding. Hospitals are self-inflicting more revenue pain, as they work to bring down re-admissions to avoid new penalties. Meanwhile, patient demand for services has softened as patients are paying more attention to their out-of-pocket costs. During the first half of this year, Fitch rating analysts downgraded eleven ...