What Does It Mean When One of America's Best Care Facilities Has to Fire Staff to Deal with Obamacare?

This is from Kim Palmer writing for Reuters and published on HuffPo (Link): 

The world-renowned Cleveland Clinic said on Wednesday it would cut jobs and slash five to six percent of its $6 billion annual budget to prepare for President Barack Obama's health reforms.

The clinic, which has treated celebrities and world leaders such as musician Lou Reed, former Italian Prime Minister Silvio Berlusconi and former Olympic gold medal skater Scott Hamilton, did not say how many of its 44,000 employees would be laid off. But a spokeswoman said that $330 million would be cut from its annual budget.

"Some of the initiatives include offering early retirement to 3,000 eligible employees, reducing operational costs, stricter review of filling vacant positions, and lastly workforce reductions," said Eileen Sheil, Executive Director of Corporate Communications for the Cleveland Clinic Foundation.

The clinic is Cleveland's largest employer and the second largest in Ohio after Wal-Mart. It is the largest provider in Ohio of Medicaid health coverage for the poor, the program that will expand to cover uninsured Americans under Obamacare.

"We know we are going to be reimbursed less," under Medicaid, Sheil said.

Cleveland Clinic has almost 100 locations around Ohio employing 3,000 doctors. Its main campus is world renowned for cancer and cardiovascular treatment.

"To prepare for healthcare reform, Cleveland Clinic is transforming the way care is delivered to patients," Sheil said without elaborating.

The clinic's Lerner Research Institute had a total annual research expenditure of $255 million in 2012 and recently announced breakthroughs in creating a breast cancer vaccine, drugs to treat Alzheimer's patients and research into the genetic mutations in prostate cancer. ...