KOKOMO, Ind.—Community Health Network, Indianapolis, signed a letter of intent to acquire Howard Regional Health System, Kokomo, Ind. County-run Howard had a deal in place in May 2011 to merge with 13-hospital Indiana University Health, Indianapolis, but the transaction crumbled in October.

Howard's board approved plans for the affiliation with five-hospital CHN on Jan. 26, according to a news release. Howard, which has two hospitals, cited the rising cost of uncompensated care, about $20.5 million in 2010, as a reason to seek affiliation. “This is up significantly from prior years. Although healthcare reform initially promised healthcare for all, the details of such a plan have not been finalized,” Howard President and CEO James Alender said in the release. Howard serves patients in north central Indiana, and according to its latest financial report released in September, the system suffered an operating loss of $5.1 million in 2010. That's after posting $3.5 million in operating income the year before. Financial terms weren't disclosed for the deal, which requires CHN to continue to operate a full-service acute-care hospital in Howard County. The letter of intent also requires that two-thirds of Howard's board be residents of the county or live in a nearby county.

DES MOINES, Iowa—Mercy Medical Center, a 567-bed not-for-profit hospital in Des Moines, said it will reorganize the hospital's physician and administrative leaders to provide better patient care across its three campuses. The hospital plans to pair a physician leader with a vice president from the administration team to manage seven service lines, said Robyn Wilkinson, Mercy Medical Center's senior vice president of human resources. The service lines include hospital-based care, primary care, specialty, cardiology, orthopedics and surgery, while the seventh line consists of women's and children's services and oncology. “With the ever-evolving landscape of healthcare reform, we believe physician engagement and leadership is key to success,” Mercy President and CEO David Vellinga said in a news release. “Mercy has always had great physician leaders, but now we're formalizing their leadership roles by clearly defining them, and engaging them to lead clinical changes and operational improvements.” Mercy Medical Center also said in the news release that the reorganization will not lead to additional administrative functions or changes in staffing. The physicians and staff who work in each service line will now report to the physician leader and administrative vice president with responsibility for that line. The hospital is part of Catholic Health Initiatives, a 55-hospital system based in Englewood, Colo.