The new federal health care law is giving millions of uninsured Americans health coverage -- and many of them are expected to get long-delayed surgeries and seek other crucial medical care.

So why are some hospitals up for sale or desperately seeking to align with others?

One reason is that the health law pressures hospitals to reduce costs and offer better value through new rules that reward them more for the quality of care they deliver than for the number of patients they treat.

"If hospitals cannot adapt and play under the new rules," said Maribeth Shannon, a director at the California HealthCare Foundation, "it will be a challenge for them to survive."

Just this month in the Bay Area, the financially strapped nonprofit Daughters of Charity Health System, based in Los Altos Hills, announced it will sell its six hospitals -- four in the Bay Area and two in Los Angeles. And last week, UCSF Benioff Children's Hospital and Children's Hospital in Oakland formally linked arms to help broaden their services and cut costs. In October, Sutter Health transferred ownership of the beleaguered San Leandro Hospital to the Alameda Health System.

Perhaps most notably, the health care law signed by President Barack Obama in March 2010 imposes significant cuts in hospital reimbursements for Medicare -- about $155 billion nationwide from 2010 to 2020. California's more than 400 general acute-care hospitals stand to lose about $17 billion, according to the California Hospital Association.

The law also reduces Medicare payments to hospitals that report excessively high rates of avoidable readmissions within 30 days of discharge for patients who were treated for heart attacks, heart failure or pneumonia.

Next year, Medicare reimbursements also will be reduced at hospitals where patients picked up an infection that lengthened their stay.

The Affordable Care Act, widely known as "Obamacare," also encourages doctors and hospitals to form "accountable care organizations." These networks of providers -- including primary care doctors, specialists, hospitals and home health care services -- work together to coordinate the patients' care.

It's a different health care model than the "fee-for-service" system that exists in the U.S. today -- in which economic incentives are built around providing more treatments, not fewer.

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New health care law: Hospitals pressured to slash costs, improve quality of care

Louise Carr.

Subacute mental health bed numbers at the hospital would be halved under a Southern District Health Board proposal.

The Otago Daily Times reported that Dunedin North MP David Clark and the Public Service Association had warned clients would have less access to highly-skilled staff such as registered nurses.

Both suggested the board was cutting costs, and would not funnel the $250,000 annual savings to community-based providers.

Pact chief executive Louise Carr said she was disappointed with what she believed was a negative portrayal of the situation.

All staff were professionally trained for their roles at a range of skill levels.

''For anyone to say community staff aren't qualified is not only incorrect, it's insulting to the people we employ.''

At present, hospital stays were longer than they needed to be because of a lack of community beds.

She was confident the board would accept the necessity of beefing up community services.

''The fact is that people are often ready to move into the community, but stay in hospital for longer than they need to because there are no beds in the community. We welcome a more flexible model.

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Mental health care defended

President Obama once said of his health care reforms, "If you have ideas about how to improve...

In his 2011 State of the Union Address, President Obama told Congress, let me be the first to say that anything can be improved. If you have ideas about how to improve this law by making care better or more affordable, I am eager to work with you.

It's been three years, and after countless empty claims from administration officials about the readiness and safety of Obamacare's implementation, leading to the disastrous launch of healthcare.gov, there is one idea the president should embrace: Repeal Obamacare.

Plain and simple.

The president's government takeover of the health care industry threatens tens of thousands of private practices with the very real possibility they could have to close their doors, leaving their long-time patients without a place to turn.

Even for the doctors lucky enough to keep their practices afloat under the weight of new overhead costs and costly regulations, they are losing their patients due to being dropped from their provider networks and not being able to provide treatment under inadequate Medicare reimbursement rates.

Just the other day, Moodys credit rating agency announced it was downgrading the outlook for health insurers on the exchanges from stable to negative reporting that the ongoing unstable and evolving environment [created by Obamacare] is a key factor for our outlook change.

The entire solvency of the system created by the president was built on the delusional notion that younger, healthier people would account for 40 percent of enrollment and allow premiums to be kept affordable.

Essentially, the administration gambled on young Americans overpaying for coverage they dont even need. On top of that, a new study revealed that its actually cheaper for 86 percent of this demographic to pay the individual mandate penalty than to buy into the Obamacare exchanges.

Not surprisingly, only 24 percent of enrollees are between the ages of 18 and 34 well short of the administrations 40-percent target.

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The best way to make health care better and more affordable is to repeal Obamacare

Originally Published: January 27, 2014 3:48 PMModified: January 27, 2014 10:38 PM

A new study shows that health care costs for severely obese patients are much higher 50 percent to 90 percent more than for those who are simply overweight, moderately obese or normal weight, said the Ann Arbor-based Center for Healthcare Research and Transformation.

Employee health programs that seek to help workers with their weight problems behavioral modification and bariatric surgery are some ways to minimize these high health costs, said "Obesity in Michigan: Impact and Opportunity."

"If Michigan health insurers, practitioners, businesses and the Department of Community Health are going to invest in reducing obesity, a targeted effort on the severely obese may have the biggest impact," said Marianne Udow-Phillips, the center's director.

More than 50 percent of severely obese people reported they were actively trying to manage their weight. More than one-third believed they would succeed, the study found.

Bariatric surgery, generally recommended for those severely obese, can reduce body weight by 20 percent to 60 percent. However, less than 1 percent of people choose bariatric surgery, which is the surgical removal of parts of the stomach and small intestines to induce weight loss.

Intensive behavioral therapy also has been found to help people lose weight. Studies have shown 12 to 26 sessions could reduce weight by an average of 6 percent.

Obesity has recently been recognized by the American Medical Association as a disease.

Using 29,691 adults covered by Blue Cross Blue Shield of Michigan, the center compared rates of those who were moderately obese with those severely obese.

The study found that the severely obese:

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Study: Obese patients drive health care costs up; intervention can help