Special report. Managers jumping into new healthcare models to survive hospital industry downsizing

The rise of managed care and risk-sharing reimbursement have hospitals shedding personnel and banding together with other providers to protect margins in the face of plummeting occupancy rates. Those forces are taking their toll on the middle levels of hospitals' administrative structures. For many hospital managers, integration and reform promise uncertainty and unemployment. How can hospitals cushion the painful blow to mid-level management? And where do managers look when restructuring leaves them out of a job? Early communication and strong support structures are crucial to easing an organization through a difficult downsizing, one hospital found. For downsizing's management casualties, industry changes are creating opportunities outside the traditional hospital management structure, executive employment experts say.