Medicare's Squeeze Play

New cost-cutting rules are socking a host of care providers

On June 30, the Visiting Nurse Association of Southeastern Indiana let go the last of its 175 employees and cleared out its offices in Jeffersonville. Facing sharply lower Medicare payments, agency managers felt they could not stay in business. "It just was not possible to cut enough to operate at those levels," says former Executive Director N. Bennett Jesse.

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