
Vanderbilt University Medical Center announces up to 650 layoffs
The big picture: The Trump administration is pursuing massive cuts to National Institutes of Health research grants and to the Department of Health and Human Services. The budget bill pending in Congress proposes deep cuts to Medicaid, which provides health insurance to 83 million low-income adults and their children.
Aggressive cuts have put research hospitals across the country on their heels.
VUMC president and CEO Jeff Balser previously warned that the federal cuts would lead to layoffs and hobbled research projects.
Flashback: In March, VUMC announced plans to slash its budget by $250 million because of the Trump administration's spending cuts. At the time, Balser said more cuts and layoffs could be needed as the scope of the funding fallout became clear.
The latest: In a new statement Friday, VUMC said operating costs would be cut by $300 million due to "budgetary actions in Washington, DC related to government-sponsored research and patient care."
Layoffs will hit up to 650 employees "primarily in research, administrative and other support areas." That total includes employees who were already laid off earlier this year as well as a new round of reductions that began Friday.
VUMC announced staffing reductions in a video message to employees.
What they're saying:"While this is extremely difficult, the staffing loss represents less than 2% of VUMC's total workforce," the VUMC statement read. Laid off employees will get severance and "other assistance."
"VUMC sees more than 3.5 million patient visits each year and remains committed to meeting the needs of all who depend on us for health care."
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles

Miami Herald
36 minutes ago
- Miami Herald
Why Florida is missing out on $200 million a year in Medicaid funding for schools
Florida lawmakers reached a rare consensus after the deadly Parkland school shooting: More money was needed for mental health counseling at schools. 'We haven't put enough resources into mental health issues,' said then-Sen. Kathleen Passidomo, R-Naples. 'And look what happens.' Two years later, lawmakers passed a bill allowing Medicaid dollars assigned to school districts to be used for more types of care for kids, including counseling. But state officials didn't adopt the changes. And they have refused to comply with federal guidelines that would help school districts provide that care. Florida schools have missed out on about $200 million a year in Medicaid funding — a total of $2.2 billion since 2014 — to support children's mental health counseling, physical therapy and other services, advocates say. Their calls to recoup funding come as schools face multimillion-dollar shortfalls in the budget year that began July 1 — and as kids struggle with the fallout from the COVID-19 pandemic. They say the problems lie with the Florida Agency for Health Care Administration, which oversees Medicaid in the state and reports to Gov. Ron DeSantis. Documents show that for more than a decade, the agency hasn't followed federal reimbursement guidelines for school-based services — one of the few areas of Medicaid the Trump administration and Congress have not targeted for reductions. The federal program provides in-school medical care and instruction for school-age children with physical or developmental disabilities who qualify for Medicaid. About 2 million children in Florida are on Medicaid, which provides free or low-cost health care to people who qualify. Without the money, school districts have struggled to find therapists, nurses and others to treat children. Some kids experienced lower-quality care or had that care delayed during critical periods of their lives, observers say. The state agency strayed from federal guidelines in 2014, when the U.S. government changed its rules regarding the reimbursements. Experts consulted by the Times said Florida is one of the few states, and perhaps the only one, that is using the outdated payment method. The federal Center for Medicaid and Children's Health Insurance Program Services warned the agency in 2020 that it was 'not in compliance with current financing rules,' but no substantial action followed. Over that time, instead of collecting $2.2 billion from federal coffers to cover school-based expenses, the state received about $250 million. With money tight, school officials want the agency to make the necessary fixes. 'This is a significant agency failure,' said Ken Kniepmann, former state assistant deputy secretary for Medicaid Policy and Quality at the agency. He was hired in part to improve the system but said he was later instructed to stop. 'It's really unconscionable. Nobody should be OK with this.' A spokesperson for the agency said it did not have sufficient funding to update its reimbursement method until this year's legislative session, and it is committed to getting it done next year. Kniepmann said the agency had not asked the Legislature for permission to draw down the federal dollars needed to enact the changes until this year. The Hillsborough County school board held a workshop in April to address the Medicaid funding gap. Hillsborough received about $6 million in Medicaid reimbursements a year ago for the services it provided, specialist Deneen Gorassini told her board, but would have gotten about $10 million more if the state agency followed federal guidelines. It's money that could have expanded medical and mental health services in schools. Other districts experienced similar-sized gaps, according to Kniepmann's calculations. 'If we can get (the agency) to do their job and submit a (state plan amendment), we could start getting reimbursed based on our expenses, which are way more than what we are getting reimbursed now,' Gorassini told the board. Since 1997, the state has been reimbursing school districts for services — such as counseling or speech therapy — based on a flat rate. In 2014, the federal government required states to reimburse school districts based on the actual costs of those services, which is much higher. Five years ago, federal officials wrote Florida telling them it hadn't adopted the change, and the state had 90 days to comply. 'Please note that you may not pay a rate from a fee schedule and use this as a certification of cost,' Center for Medicaid and CHIP Services acting director Todd McMillion wrote Florida officials in March 2020. The center said it is working with the state to resolve the concerns listed in that letter. Florida is still paying schools a flat rate that has changed little since 1997. Karen Thomas, a Medicaid specialist for Leon County schools for more than 20 years, said that while the formulas are complex, the solution should be 'extremely simple.' 'We're 90% there, maybe 95% already, in the way we are doing things,' Thomas said of districts' processes for collecting receipts and monitoring providers' time. 'They have everything they need to be in compliance with federal payment methodology. They just need to change the invoice, one line on the invoice. ... The fault is squarely in the agency's failure to come into compliance.' The state has shown it can make the switch, Thomas said. She pointed out that when federal authorities ordered county health departments to start billing for actual costs instead of flat rates in 2020, the state quickly shifted. She noted that school-based services are 'a very niche portion' of the state's Medicaid budget — somewhere in the neighborhood of 1% — and that over time agency officials have paid less attention to them, decreasing communication with school districts and reducing staff dedicated to the service. The issue shouldn't be a side note, as it affects the lives of some of Florida's neediest children, she said. And the pandemic made kids' mental health a national crisis. 'Kids used to miss school because of asthma,' Thomas said. 'Now they're missing school because of anxiety and depression.' After the 2018 Parkland attack, state lawmakers wanted to make sure students were getting proper mental health assistance in schools. In 2020, they passed legislation allowing schools to use Medicaid dollars for other types of care. DeSantis signed it into law. But his Agency for Health Care Administration never rewrote the agency's rules to allow school districts to use the new law. 'The law was very clear,' said retired Sen. Bill Montford, D-Tallahassee, who sponsored the 2020 bill. 'Why they didn't do it I don't know.' Rep. Christine Hunchofsky, a Democrat who represents Parkland in the House, repeatedly has asked agency officials if the state is doing all it can to leverage federal money for student services. The issue comes up frequently on the Commission on Mental Health and Substance Use Disorder, to which Hunchofsky was appointed by the Republican House speaker. She said the agency has provided few clear answers. Meanwhile, she's heard plenty from the school districts, and said she plans to pursue the questions further. Montford, also executive director of the state's superintendents association, said agency officials have told his group that they are preparing a rule revision to go into effect in mid-2026. That's when states are supposed to comply with an updated 2023 federal guidance on school-based services. But Kniepmann, who worked as associate director for health at the Florida Conference for Catholic Bishops before moving to the health agency, argued the state is stalling for reasons that remain unclear to him. He said the 2023 guidance was not intended to be a way for Florida to further delay implementing rules put in place more than a decade ago. Every holdup, he and others said, means less money available to pay for medical and related services. 'Eleven years and $2.2 billion is not a little thing,' he said. Hillsborough district officials, also leery of the state's ability to pull off a new rule by mid-2026, said they are looking into a different approach to bring in more Medicaid money. Gorassini told the board that her department would conduct a rate study for each service it provides and submit the updated amounts to the state for inclusion on the existing reimbursement schedule. Kniepmann said it's a long-shot effort that requires a lot of work at the district level, adding that the agency has discouraged such an approach. It's worth a shot, though, Gorassini told the Hillsborough school board. 'We'll never get what we spend,' she said. 'But in the meantime we're going to try to maximize our reimbursement.' What's really at stake is student health, said Thomas, the Leon County Medicaid specialist who also serves on the National Alliance for Medicaid in Education leadership team. Her district stands to reap about $2 million more per year if the change is made. 'That is the difference between being able to hire actual medical professionals who have the ability to recognize actual medical issues, and purchase medical equipment, actual things that could help the children that are most medically needy in this county,' she said. 'When I can't afford to pay for a nurse, all kids suffer.'


Boston Globe
2 hours ago
- Boston Globe
Dozens gather at Boston Medical Center to protest Trump''s ‘Big Beautiful Bill,' cuts to Medicaid
Donald Trump's tax bill, which he signed into law on July 4, will strip about $186 billion from SNAP and close to $1 trillion from Medicaid over the next decade, the Globe Advertisement The bill could strip healthcare coverage from some 250,000 Massachusetts residents, Governor Maura Healey Advertisement Republicans frame the bill as a way to target Medicaid fraud and save money. It would require states to 'We're here to expose the harm of this big, bad bill that will transfer wealth from working people to wealthy people,' said Marlishia Aho, the regional communications director for 1199SEIU. Franswa Jean-Enard, a personal care attendant for his mom and a member of the union, said he's anxious his mom could be stripped of her healthcare benefits 'at any time' because of the cuts even though he has 'all the paperwork to justify her need for it.' She has several conditions, including advanced arthritis, and relies on Medicaid for 'all her care,' including physical therapy and medication. Jean-Enard said it was important for him to protest because even if he isn't ultimately affected, he doesn't want other people to lose access to life-saving treatment. 'Back home in Haiti, there's a saying — when your friend's or neighbor's beard is on fire, put yours in order — which means when something is happening to your neighbor, it could happen to you,' he said. The state requiring more frequent eligibility checks would also be a burden, as Jean-Enard said the paperwork for his mom's Medicaid is already time-consuming and can take months to process. 'I'm hoping it doesn't get to that, but I'm hoping with the help of the union, what we're doing and organizing, we can push back,' he said. Advertisement Jean-Enard said he understands the government wants to streamline spending, but that it shouldn't come at the expense of healthcare. 'Every single PCA is doing crucial work,' he said, adding that his mom's needs will only grow with time. Janice Guzman, also a PCA for her mom, was cut from 'That's why I'm here, fighting back,' Guzman said. 'My mom needs my assistance 24/7 — and I don't get paid for 24/7 — but it's helping me pay my bills. Right now, it's like, what am I going to do?' Others at the protest, like 70-year-old Fe Guidry, a PCA in New Bedford, said they're worried about cuts to SNAP, which Guidry said SNAP 'really helps' her purchase healthy food. 'We're fighting for the benefits that we have,' she said. Emily Spatz can be reached at


UPI
6 hours ago
- UPI
The difference between palliative care and hospice
If a doctor diagnoses you with a serious illness and suggests palliative care, don't jump to conclusions. It doesn't mean you have mere months to live, NIH News in Health emphasizes. Palliative care, which is focused on comfort care and symptom management, may be recommended at any stage of a chronic or serious illness. But it is often confused with hospice care, which is comfort care for patients in the final months of life and requires that all treatments be discontinued. "Embracing palliative care does not mean that you're giving up on treatment," said Alexis Bakos, an aging expert at the National Institutes of Health. "Ideally, palliative care should be offered at the very beginning of a diagnosis of any serious illness." Diagnoses like chronic heart and lung disease, cancer and neurodegenerative illnesses like dementia and Parkinson's all fall under the definition of "serious." These illnesses lower a patient's quality of life or ability to perform everyday tasks like cooking or bathing. A palliative care team can help patients cope with physical, psychological, emotional or spiritual suffering associated with these diagnoses, according to News in Health. They can not only help patients manage symptoms but also assist providers in coordinating complex care. Dr. Matthew DeCamp, a physician at the University of Colorado, Anschutz Medical Campus, describes palliative care as a "holistic approach" to medicine and caregiving. "It places the patient's quality of life and needs and values front and center," he told News in Health. A pallative care provider typically meets with a patient soon after they are diagnosed with a serious disease to explain the many ways they can lend a hand - from help coordinating care to helping patients create an advance directive, which spells out their wishes for care if they become unable to speak for themselves. "They will learn your preferences for care and communication," said Dr. Lori Wiener, a palliative care expert at the NIH. Many patients welcome the assist, because planning for a serious illness is often complicated. "Patients and families often remain unaware of how their serious illness may progress," DeCamp said. "They may not know how long they might be expected to live or how long or what types of symptoms they might have. Physicians, nurses and other members of the care team are also historically not very good at predicting the course of a disease." These days, AI tools can help with that. But not all doctors use them and when they do, patients might misinterpret findings they spot in their medical records, said DeCamp, who is studying ethical issues surrounding use of AI. Weiner's team, which is studying ways to help kids with cancer communicate their wishes to family and health care providers, has created a guide called "Voicing My CHOiCES" that helps teens and young adults consider and spell out their hopes, fears and values. It has also developed an electronic screening tool called "Checking IN," which helps doctors understand what, specifically, distresses their young patients so they can be better prepared for visits. Palliative care specialists can help patients understand their prognosis and their treatment options - and help them be comfortable. So NIH experts urge patients who are diagnosed with serious illnesses to ask their doctor about palliative care if it isn't offered to them right away. "Earlier NIH research was focused on making sure that primary care clinicians were aware of palliative care," Bakos said, adding that NIH is looking now at ways to involve more specialists such as E.R. doctors, neurologists and ICU providers into discussions of palliative care. More information Learn more about palliative care and hospice at the National Institute on Aging. Copyright © 2025 HealthDay. All rights reserved.