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New York City’s public hospital system “is on the edge of a financial cliff,” Mayor Bill de Blasio’s administration is warning in a report to be released on Tuesday as part of his budget, which proposes a restructuring and an infusion of $2 billion in subsidies. Along with a push for new revenue and new savings for the system, Health & Hospitals, the city subsidy — a $700 million increase over the 2016 fiscal year — is intended to shrink a gap that is projected to balloon to $1.8 billion by 2020, up from a current $600 million shortfall. (Bernstein, 4/25)

Mayor Bill de Blasio’s administration will propose an overhaul of the cash-strapped public-hospital system in the city’s budget presentation on Tuesday, people familiar with the matter said. The overhaul is expected to turn inpatient centers—which are more expensive but often prized by communities—into outpatient centers and focus less on emergency rooms, one of these people said. It will include retraining some employees, adding billions to the system’s budget as changes are made, and attempting to revise the formula on how health care is funded. (Dawsey, 4/25)

Hospital operator mergers have created big—sometimes behemoth—health systems that will provide the scale necessary to achieve operating efficiencies and compete for more cost-conscious consumers. So they say. But some of the biggest mergers in recent years have so far failed to deliver on that promise. ... their stumbles are renewing concern that mergers and acquisitions are not the best path for achieving those efficiency and competitiveness goals. (Evans, 4/23)

About one-fourth of Georgia hospitals received an “A” grade on patient safety in newly published ratings. That percentage, determined by the Leapfrog Group, is down from this past autumn, when one-third of Georgia hospitals got an “A” in the organization’s rating (Miller, 4/25)

One of the governor’s options to patch a hole in the state budget includes a $35 million cut from the Kansas Department of Health and Environment, a move a hospital group says could harm its members. Gov. Sam Brownback laid out three proposals to patch the budget hole last week after revenue projections for this budget year and the next were lowered by $350 million. One of the options includes the $35 million KDHE cut. (Hart, 4/25)

The need to protect against earthquakes is about to jolt the municipal junk-bond market from its slumber. California’s Loma Linda University Medical Center on Wednesday is planning the biggest speculative grade, tax-exempt health-care deal since at least 1990, according to data compiled by Bloomberg. The $883 million sale will finance an expansion and overhaul to comply with the state’s seismic safety requirements, a project that will double the center’s debt and triggered a fall from investment grade last year. (Varghese, 4/26)