How one New York hospital is moving to head managed care off at the pass. Interview by Jim Montague.

Like tremors before an earthquake hits, managed care and projected cuts in Medicare and Medicaid are shaking up New York even before they arrive. Many of the city's largest hospitals hope to cushion the shock waves from lost referrals for inpatient care by buying primary care providers, though it's likely many of these efforts will be too little, too late. But a handful of New York's providers have been prepping for managed care's growth, allowing them to address it more on their terms. Mount Sinai Medical Center is so confident its advance work will succeed that it actually is adding a few beds, not closing them. John Rowe, M.D., president of the medical center and the Mount Sinai School of Medicine, spoke recently with H&HN staff writer Jim Montague about Mount Sinai's strategies.