This was not his first visit to the CEO’s office.In his 21 years at Mercy Hospital, Dr. Jonathan Smith had always been a strong advocate of patient safety and he never hesitated taking his concerns to the top. However, today was different. Bob Moore had been CEO only two months and he had already championed several new initiatives to achieve the 10-percent cost reduction goal for the year. He did not waste any time on small talk.

“Jon, I wanted to talk to you about your group. You guys have been here pretty much since the hospital opened, right?”

Jonathan nodded.

“I’ve been looking over the finances … we pay you about $2 million in subsidies, is that correct?” asked Bob, looking down at the small pile of papers in front of him.

Jon knew where this was going …

How many times had he decried the word “subsidy,”...

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