The Columbus Dispatch reports a January snapshot by iVantage Health Analytics found hospitals in the state's metropolitan counties were running slightly in the black, while those in non-metro counties - often the largest employers - showed narrow losses.
Struggling hospitals in Washington Court House and Coshocton have closed maternity units. Hospitals in Chillicothe and Zanesville saw bond ratings downgraded. Hospital workers in Gallipolis face possible layoffs, while OhioHealth is closing its inpatient hospital in Nelsonville.
The newspaper reports the Affordable Care Act has begun to address the costs of the uninsured and could also cut into charity-care costs, particularly in states such as Ohio that have expanded Medicaid.