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The Service Employees International Union is pushing a ballot initiative that would divert millions of dollars from Partners HealthCare to lower-paid competitors in an effort to boost community hospitals and preserve union jobs. Payments to hospitals vary widely under the contracts they strike with health insurers, and larger health systems, which provide a range of specialized services, can use their market power to extract higher payments. (Dayal McCluskey, 8/5)

Desperate for a deal to save its beleaguered hospitals, Bay Area-based Daughters of Charity Health System was left at the altar this spring when California's Attorney General told its prospective new owner it must keep most of the hospitals open for at least 10 years. (Seipel, 8/4)

UnitedHealth Group is expanding a program with Mayo Clinic that encourages patients across the country to travel to the Rochester-based health system for certain specialized procedures. For more than 10 years, Mayo Clinic has been designated by the Minnetonka-based insurer as a “center of excellence” for organ transplants, which means health plans offer incentives if patients travel to Rochester for care. Under an agreement being announced Wednesday, the program will expand to include cancer, bariatric surgery, heart failure, congenital heart disease and infertility services. (Snowbeck, 8/5)

The equipment closet for the operating rooms at Los Angeles County Harbor-UCLA Hospital was a mess. Nurses had to maneuver through a maze of wheelchairs, beds, boxes and lights to find the necessary surgical supplies. 'It looked kind of like a dog pile of equipment,' said Dawna Willsey, a clinical director at the hospital. 'It was every man for themselves trying to find anything.' As public hospitals like Harbor-UCLA try to cut costs and make patients happier, administrators have turned to an unlikely ally: Toyota. They are adapting the car maker’s production system to healthcare, changing longstanding practices such as how to store equipment, schedule surgeries and discharge patients. The philosophy, known as lean, depends on a continuous team effort to pare inefficiency and improve quality. (Gorman, 8/5)

Nonprofit hospitals get billions of dollars in tax breaks every year, but a new study shows that they may not be giving back very much to communities in return, as intended by law. The study, out of the University of California San Francisco, found that some tax-exempt hospitals are spending as much on free or subsidized care as their for-profit counterparts. The authors say that's because the criteria to have tax-exempt status is vague, specifically under the Affordable Care Act. (Gebelhoff, 8/4)