Miami medicine goes digital

About 10 years ago, Dr. Fleur Sack quit her practice as a family physician to become a hospital department head. Spurring her decision was the need to switch from paper records to electronic ones to keep her private practice profitable. “At that time, it would have cost about $50,000,” Dr. Sack recalled. “It was too expensive and it was too overwhelming.”

But times and technologies changed, and last year, Dr. Sack left her hospital job to restart her medical practice with an affordable system for managing electronic patient records. She agreed to a $5,000 setup fee and a subscription fee of $500 per month for the system. Her investment also qualified her for subsidy money, which the federal government pays in installments, and to date, her subsidy income has paid for the setup fee and about two years of monthly fees. “So far, I’ve got my check for $18,000,” she said. “There’s a total of $44,000 that I can get.”

That kind of cash flow is one reason why so-called EHR software systems for electronic health records have been among the hottest-selling commercial products in the world of information technology. EHR system development is a growth industry in South Florida, too. Life sciences and biotechnology are among the high growth-potential sectors identified by the Beacon Council-led One Community One Goal economic development initiative unveiled in 2012; already, the University of Miami has opened a Health Science Technology Park while Florida International University has launched a program in its graduate school of business oriented toward biotechnology businesses.

For many young businesses in the area’s IT industry, government incentives are paving the way. The federal government is pushing doctors and hospitals to use electronic health records to cut wasteful spending and improve patient care while protecting patient privacy — sending digital information via encrypted systems, for example, rather than regular email.

Under a 2009 federal law known as the HITECH Act, maximum incentive payments for buying such systems range up to $44,000 for doctors with Medicare patients and up to $63,750 for doctors with Medicaid patients. Hospitals are eligible for larger incentive payments for becoming more paperless. The subsidy program isn’t permanent; eligible professionals must begin receiving payments by 2016. But by then, the federal government will be penalizing doctors and hospitals that take Medicare or Medicaid money without making meaningful use of electronic health records.

“What the government did is, they incentivized, and now they’re going to penalize,” said Andrew Carricarte, president and CEO of IOS Health Systems in Miami, one of the largest South Florida-based vendors of online software service for physician practices. He said insurance companies also may start penalizing physicians for failing to adopt electronic health records because “the commercial payers always follow Medicare and Medicaid.”

It’s all part of the growth story at IOS Health Systems, which has more than 2,000 physicians across the nation using its online EHR system. Carricarte said many of the company’s customers buy their second EHR system from IOS after their first one flopped. “Almost 40 percent of our sales come from customers who had systems and are now switching over to something else,” he said.

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Opinion: Salute to the Brothers to the Rescue fliers shot down on this day by Cuba

I was 5 years old and strapped to a tall pole across from my 3-year-old sister. The pole, a mast for a sail that was never very useful, was in the center of a raft being thrown about the Florida Straits.

I don’t remember the nights, but I’m told they were so dark my mother, sitting between us, could not see us, but only feel us. I don’t remember being wet or cold, but my parents tell me the waves rolling over us were about 20 feet high. I don’t remember the sun, but after four days at sea, my skin was two shades darker than what most women would pay for at a tanning salon.

If there were a soundtrack to my life, Willy Chirino’s Nuestro Día (Our Day) would be one of the first songs on the album. The first two verses always bring tears to my eyes and remind me of the danger my family was in when Brothers to the Rescue saved our lives. Brothers to the Rescue is the organization whose pilots kept a watchful, protective eye for rafters making the perilous journey from Cuba to freedom. It was 17 years ago today that four of them were ambushed in the sky and killed by Cuban MiGs.

Tired of living in a country where he was persecuted for uttering disapproval of the government’s hateful policies and tactics, my father, then 25 years old, decided it was time to leave. My mother refused to stay behind with two young girls and no future. So after hiding in a military neighborhood for most of the summer of 1992 — and six days after Hurricane Andrew had destroyed Homestead — my family left Cuba.

We left just before dawn through the middle of Varadero, a popular, and hence heavily patrolled, beach. We left on a raft engineered and built by my father with the help of a few other men who left with us.

There were nine of us — although it nearly became 10. My parents tell me that a drunk who was walking the beach helped push the raft away from the shore, then begged to come with us. But our food and water supplies were carefully rationed for nine. Our vessel, if you could call it that, was full.

I remember only snippets of that night. Mostly, I recall darkness, tall grass, running on the sand, and my little sister crying while my mother tried desperately to keep her quiet.

Though it was four days and two more nights before we were spotted by Brothers to the Rescue, the next thing I remember is eating delicious pastelitos. A creative humanitarian in that plane fashioned a parachute, out of a cardboard box filled with Cuban pastries from Miami, and tied it to an actual message in a bottle. The sweet parachute fell to the water and bobbed around just close enough for someone in our party to reach.

My mother recalls it was the first food in almost a week that my sister and I were able to keep down.

The “bottle,” a clear plastic jar with a white sticker and bold red letters that read: “Hermanos Al Rescate” — Brothers to the Rescue — held a message that had my sister and I standing and waving excitedly up at the sky: “Don’t despair. God is with you and the U.S. Coast Guard is on its way from Key West.”

I am now 26, and that plastic jar has had a place of honor in our family’s kitchen for over 20 years.

Today it is filled with coffee beans my aunt sent from Cuba when she heard we were alive and safe.

Since Feb. 24, 1996, these memories are tinged by sadness. That is the day I heard that two Brothers to the Rescue planes had been shot out of the sky by Cuban military planes.

As a 9-year-old child, I don’t think I understood what was going on. All I knew then of Brothers to the Rescue was that we had one of their bottles in our kitchen, and that they had sent us delicious pastries when we couldn’t keep down the tinned spam my mother had tried feeding us on that raft.

Today I am a young Cuban-American about to graduate from law school. When I see the plastic jar, I think of those men who died in the shootdown and wonder if they could have been the same pilots involved in my own family’s rescue.

I may not have known them personally, but they have my eternal respect: Carlos Costa, Armando Alejandre Jr., Mario de la Peña, and Pablo Morales.

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Independent Spirit Award Winners 2013

The 2013 Film Independent Spirits Awards were handed out in Santa Monica, CA today and lots of Oscar frontrunners cemented their status by dominating in their categories once more.

Check out all the winners below:

Best Feature

Beasts of the Southern Wild

Bernie

Keep the Lights On

Moonrise Kingdom

Silver Linings Playbook

BEST FEMALE LEAD

Linda Cardellini, Return

Emayatzy Corinealdi, Middle of Nowhere

Jennifer Lawrence, Silver Linings Playbook

Quvenzhane Wallis, Beasts of the Southern Wild

Mary Elizabeth Winstead, Smashed

BEST MALE LEAD

Jack Black, Bernie

Bradley Cooper, Silver Linings Playbook

John Hawkes, The Sessions

Thure Lindhardt, Keep the Lights On

Matthew McConaughey, Killer Joe

Wendell Pierce, Four

BEST SUPPORTING FEMALE

Rosemarie DeWitt, Your Sister's Sister

Ann Dowd, Compliance

Helen Hunt, The Sessions

Brit Marling, Sound of My Voice

Lorraine Toussaint, Middle of Nowhere

BEST SUPPORTING MALE

Matthew McConaughey, Magic Mike

David Oyelowo, Middle of Nowhere

Michael Pena, End of Watch

Sam Rockwell, Seven Psychopaths

Bruce Willis, Moonrise Kingdom

BEST DIRECTOR

Wes Anderson, Moonrise Kingdom

Julia Loktev, The Loneliest Planet

David O. Russell, Silver Linings Playbook

Ira Sachs, Keep the Lights On

Benh Zeitlin, Beasts of the Southern Wild

BEST SCREENPLAY

Wes Anderson & Roman Coppola, Moonrise Kingdom

Zoe Kazan, Ruby Sparks

Martin McDonagh, Seven Psychopaths

David O. Russell, Silver Linings Playbook

Ira Sachs, Keep the Lights On

For the full list of winners, click here.

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Man nearly hacks wife to death with meat cleaver

Gregory P. Mango

Crime tape at the scene of today's fight

A meat cleaver-wielding maniac attacked his wife in front of two New York firefighters, who had been trying to break up their fight, officials said.

The man and woman were loudly arguing in front of Fong’s Trading at 74 Canal St. at 10:24 a.m. when two of New York’s Bravest—stationed across the street at Engine Company 9, Ladder Company 6—saw the dispute and tried to intervene, according to FDNY spokesman Jim Long.

That’s when the man allegedly pulled out a meat cleaver and began hacking at his wife.

“He got a couple of good hits in,” Long said. “He hit her several times.”

Both firefighters tackled the cleaver-wielding man and held him for cops, Long said. The man was booked into custody at the 5th Precinct station house in Chinatown.

As the man was tackled, the woman took off running, leaving her thick, wedge shoes and clumps of bloody hair behind, witnesses said.

A third Bravest and two neighborhood cops on patrol chased the injured woman and finally caught up with her at Division and Eldridge Streets, witnesses said.

They calmed her down and called paramedics, witnesses said. She’s listed in critical condition at Bellevue Hospital but is expected to survive her wounds, officials said.

"She was running down the street screaming, `Help!’ ” said witness Jose Mendez, 56, superintendent of Eldridge Street Synagogue and other neighborhood buildings.

Before cops and the firefighter could reach the woman, she ducked into a small noodle shop at 13B Eldridge St., came out and ran another half block.

“She was barefoot and went into the restaurant and then ran back out,” Mendez said. “There was blood on the window. They cleaned it up right away. It was pretty weird."

Additional reporting by Wilson Dizard and David K. Li

Gregory P. Mango

Another shot of the near-fatal scene

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South Beach Wine & Food Festival changes Miami's culinary scene, impacts economy

For Miami restaurateurs, this is Showtime.

With dozens of top chefs — Bobby Flay, Todd English, Daniel Boloud and Masaharu Morimoto among the list — in town for the South Beach Wine & Food Festival, the pressure is on everywhere, from Michy’s to the new Catch Miami. The goal: Show everyone from around the country that Miami’s food scene has arrived on the national stage.

Chef Michelle Bernstein’s staff whipped up dishes designed to impress guests at Michy’s — like foie gras, oxtail and apple tarte tatin — while she juggled menus for multiple events. Bernstein kept her cellphone handy to make sure any chef friends could get a table, even though her namesake restaurant was sold out.

As always, Joe’s Stone Crab was a must-do stop for many, including Paula Deen and New York restaurateur Danny Meyer. Aussie Chef Curtis Stone attracted a string of admirers as he ate his way around town, with stops at Prime 112, Pubbelly Sushi and Puerto Sagua. Khong River House and Yardbird Southern Table & Bar hosted Meyer, The Food Network’s Anne Burrell and Chef Anita Lo.

Michael’s Genuine was another hot spot.

“This is kind of our coming out party for Khong and it’s our chance to knock it out of the park and wow people,” said John Kunkel, owner of Khong and Yardbird.

Prime 112 owner Myles Chefetz admits he’s a fanatic about checking plates when they come back from a chef’s table. And he’s always on the lookout for the table ordering 20 different items, because that’s usually a restaurateur doing research.

“If you have Jean-Gorges or Bobby Flay eating at your restaurant, you want to make sure he has a great experience,” Chefetz said. “You want to put your best foot forward because you know you’re going to get scrutinized.”

The Food Network South Beach Wine & Food Festival is not just a forum for impressing the culinary elite. It’s among the top three tourist draws for Miami restaurants and hotels. In its 12th year, the festival draws more than 60,000 people to Miami Beach for a weekend of decadence, featuring more than 50 events spread over four days.

It is neck and neck with two of the area’s other most prominent weekends: Art Basel and Presidents’ Day (which coincides with the Miami International Boat Show).

There’s the immediate economic impact, of course, but the festival has made its mark in other ways: helping transform Miami’s food scene from a cultural wasteland to one of the country’s hot spots, one where top chefs all want to set up shop.

“Twelve years ago I don’t know if you could even name five really good restaurants. Now, you can’t think of where you want to eat because there are so many good restaurants,” said Lee Brian Schrager, festival founder and vice president of communications for Southern Wine & Spirits, its host. “What the festival can take credit for is introducing the culinary world to the great talent down here, and really highlighting South Florida as a great dining destination.”

There has been plenty of indulgence to go around. Flay finally broke his losing streak and took home top honors at the Burger Bash with his award-winning crunchified green chili burger. At the Q, barbecue lovers had their choice of Al Roker’s lamb ribs with baked beans or Geoffrey Zakarian’s smoked tagarashi crusted tuna, among other offerings.

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Miami police union challenges officer’s firing for fatal shooting

The Fraternal Order of Police filed a lawsuit against the city of Miami on Friday, asserting that an officer who fatally shot an unarmed motorist in 2011 was improperly fired from the police department.

Officer Reynaldo Goyos shot and killed Travis McNeil as he sat in a car at a Little Haiti intersection. It was one of a string of seven deadly shootings of black men in the inner city by Miami police officers in 2010 and 2011.

Goyos was cleared of criminal wrongdoing by prosecutors in 2012. But he was terminated last month after the department’s Firearms Review Board concluded that the shooting was unjustified.

The police union lawsuit claims that the board violated state open-government laws by failing to open its meetings to the public.

Goyos “was improperly terminated by the city of Miami Police Department by a review board that violates the law,” union President Javier Ortiz wrote in a statement.

The lawsuit contends that Goyos should be reinstated.

City Attorney Julie O. Bru declined to discuss the specifics of the case. “We reviewed the allegations, and the city maintains that the board has operated consistent with the requirements of law,” she said.

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Buzzmakers: Prince Michael Reports for ET and Mindy McCready Dies

What had ETOnline readers buzzing this week?

1. Prince Michael Jackson is New ET Correspondent

Having grown up in show business, Prince Michael proved to be a gifted interviewer as he conducted his first sit-down as an ET correspondent.

Michael Jackson's 16-year-old son impressed Oz the Great and Powerful stars James Franco and Zach Braff as well as director Sam Raimi with his confidence and competence on his first assignment.

"You're doing awesome," Braff gushed. "You're a natural."

Prince Michael returned the compliment, praising their work in the fantasy flick and getting Franco to shed some light on how he approached playing the lead role of Oscar Diggs, a small-time circus magician with dubious ethics.

"I saw that his particular transformation would allow for comedy," Franco explained. "Because he's a conman -- that would get him into a lot of awkward situations that could be played for comedy."

The movie imagines the origins of L. Frank Baum's beloved character from The Wizard of Oz. After Oscar Diggs (Franco) is hurled away from dusty Kansas to the vibrant Land of Oz, he first thinks he's hit the jackpot -- until he meets three witches, Theodora (Mila Kunis), Evanora (Rachel Weisz) and Glinda (Michelle Williams), who are not convinced he is the great wizard everyone's been expecting.

2. Country Music Stars Mourn Mindy McCready's Death

The country music community is mourning the loss of one of their own. Country crooner Mindy McCready was found dead of apparent suicide on Sunday, Feb. 17, at her Arkansas home. She was 37. Needless to say, this has caused an outpouring of sympathetic tweets from McCready's musician peers.

Here are some of the stars' reactions to the tragic news:

LeAnn Rimes: "Mindy and I both started our careers around the same time. We worked with a lot of the same people, so we ended up spending lots of time around one another. She was always so kind and very protective of me, like a big sis. My heart is broken that she's gone."

Carrie Underwood: "I grew up listening to Mindy McCready...so sad for her family tonight. Many prayers are going out to them..."

Clay Aiken: "I listened admiringly to Mindy McCready growing up. May she finally be at peace and lend her beautiful voice to heaven's."

Lady Antebellum's Hillary Scott: "My heart is breaking hearing of the loss of Mindy McCready. Pray for her 2 precious little boys...may God's peace & protection be on them!"

Jason Aldean: "Just heard about Mindy McCready. My thoughts and prayers are with her 2 boys and her family."

Big and Rich's John Rich: "Very sad to hear about Mindy McCready. When I was in Lonestar she was our label mate and we were friends. A tragic end to a talented life."

Wynona Judd: "Oh my! Mindy. Dear sweet girl. This is so sad. It just breaks my heart what addiction continues to take from this life. Addiction is a dis EASE and not a character flaw. When the pain becomes too much, it causes people to want that pain to stop. This is just so Unbelievable and so sad. God be with the family and those babies. Surround them with your grace & mercy. Sleep in Heavenly peace Mindy."

Martina McBride: "So sad."

Chely Wright: "Really really sad to learn the news about Mindy McCready. I will pray for her children and I hope that people are gentle with her memory."

Gretchen Peters: "So sad to hear about Mindy McCready. I met her in the first flush of her early career. This is a hard business. Sometimes success is poison."

3. Mark Hamill Reveals He's in Talks to Appear in New 'Star Wars'

Mark Hamill's new movie Sushi Girl hits DVD and Blu-ray this week, and while talking about the project, the Star Wars legend was more than happy to provide ETonline with an update on his involvement with the in-development Star Wars VII – and what he thinks of those planned spinoff movies…

"It's all very, very exciting and so unexpected," says Hamill. "I think that's the quality I like about it most – it's like getting a pair of pants out of the closet you haven't worn in three years and finding a $20 bill in the pocket. It's just so unexpected."

First off, will he appear in Star Wars VII? "They're talking to us," he reveals. "George [Lucas] wanted to know whether we'd be interested. He did say that if we didn't want to do it, they wouldn't cast another actor in our parts – they would write us out. … I can tell you right away that we haven't signed any contracts. We're in the stage where they want us to go in and meet with Michael Arndt, who is the writer, and Kathleen Kennedy, who is going to run Lucasfilm. Both have had meetings set that were postponed -- on their end, not mine. They're more busy than I am."

Hamill, 61, says he's intrigued about where the new trilogy could go but says he knows nothing about the storyline: "I probably learn more from Entertainment Tonight than I do directly from Lucasfilm – like for instance, when George told us he wanted to do the next trilogy, he didn't tell us it was going to be done for Disney. He saved that little nugget, and I read it online like anybody else."

As for his thoughts about the next trilogy's tone, "I said to George that I wanted to go back to the way it was, in the sense that ours was much more carefree and lighthearted and humorous – in my opinion, anyway. And another thing I'd want to make sure of is are we going to have the whole gang back? Is Carrie and Harrison and Billy Dee and Tony Daniels, everybody that's around from the original [returning]? I want to make sure that everybody's on board here, rather than just one. I guess I'll have to tune into your show to figure out who's on board."

In terms of where we'll pick up with Luke Skywalker in Star Wars VII, "I'm assuming, because I haven't talked to the writers, that these movies would be about our offspring -- like my character would be sort of in the Obi-Wan range [as] an influential character. … When I found out [while making the original trilogy] that ultimate good news/bad news joke – the good news is there's a real attractive, hot girl in the universe; the bad news is she's your sister – I thought, 'Well, I'm going to wind up like Sir Alec [Guinness]. I'm going to be a lonely old hermit living out in some kind of desert igloo with a couple of robots.'"

Hamill concludes of the next movie, "I hope they find the right balance of CGI with practical effects. I love props, I love models, miniatures, matte paintings -- I'm sort of old school. I think if you go too far in the direction of CGI it winds up looking like just a giant a video game, and that's unfortunate. … If they listen to me at all, it'll be, 'Lighten up and go retro with the way it looks.'"

As for those confirmed stand-alone Star Wars films, which may follow the adventures of a young Han Solo, Boba Fett and Yoda, Hamill observes, "That's really smart. Then you're more like James Bond pictures, where they come out and it's not an investment of a three-movie arc. … It's so rich, that [Star Wars] universe, in terms of quirkiness and oddball [nature]. We would talk about that [on the original film's set]. We'd go like, 'That little band that's playing in the Cantina, what's their story?! I mean, are they a traveling band? Are they the house band? Who's their manager?' They didn't have names when we first were talking about them. Now they're called, like, Sy Snootles – they come up with names down the road when they have to name toys."

So what spinoff movie would Mark Hamill like to see? "Oh, I don't know, set it on the Wookiee planet -- although that might be prohibitively expensive with that many Wookiees," he says with some resignation. After a little more thought, he muses, "That's what I would love. You pick the most insignificant little [character] – there's this little hawk-beaked character that's somewhere in Jabba's palace, I can't even remember what function he served -- but that's what I would think. You pick something that almost nobody remembers or knows about -- and then have a movie about him! You could probably put about 500 different character's names on a big, giant dart board, throw a dart, and say, 'Okay, wherever it lands we've got to make him the central character.'"
After a hearty laugh, Hamill adds, "I hope we don't overstay our welcome."

4. Nina Dobrev Reflects on Shocking 'Vampire Diaries' Death

Death has loomed large over Elena Gilbert since The Vampire Diaries pilot, but absolutely nothing will compare with the pain she's forced to endure now that her brother, Jeremy, has fallen victim to vampires.

The shocking death not only devastated fans, but the actors -- Steven McQueen included -- as well. And anyone assuming TVD finds a way to make the best of a bad situation is wrong. Dead wrong. According to Nina Dobrev things are about to get real dark for Elena, whose grief will make her unrecognizable to fans in the coming weeks.

ETonline: This season has been a thrill from the start. What's your feeling about season four?

Nina Dobrev: It's been really cool, especially because you always hear actors say doing a TV show for X amount of years can be boring and repetitive, but over the last four years, Elena has been changing and evolving and growing so much. Julie [Plec, executive producer] has done such an incredible job of keeping it fresh and exciting and making me excited to come to work every day. Especially this season -- and especially with the death of Jeremy. Between last week's episode and this week's, it's been very challenging for me as an actress, but very fulfilling. It's an emotional rollercoaster and I had to go to some dark places.

ETonline: What was your reaction to finding out Jeremy would be killed?

Dobrev: I think we were all shocked and surprised, but that's the show -- it's a vampire show, people have to die all the time. And for Elena, it was very important that she lose Jeremy for what she's about to go through. It becomes a big part of her journey. I know Steven was very bummed, but also excited because he had a lot to do leading up to it -- his character grew and became so strong. It's bittersweet but made for some amazing television.

ETonline: In many ways, Jeremy was the person who really kept Elena tethered to her humanity. Will this loss threaten to make Elena embrace the less desirable sides of vampirism?

Dobrev: Jeremy was the last person she had left, so it's very likely that Elena could go off the deep end now that she doesn't have the one thing that kept her human. Elena wants to protect the people she loves and saw this new-found strength as a way to protect everyone. But, in this case, she couldn't protect Jeremy and lost the only family member she had left. She won't take it lightly. It's going to destroy her.

ETonline: Jeremy was also one of the only remaining characters who touched everyone in Mystic Falls. Will his death, in some ways, reinforce the group?

Dobrev: They do come together, but everyone is sort of walking on pins and needles around Elena so they don't trigger something and send her into a psychotic break. They live in a mystical world, so just because Jeremy's dead, it doesn't mean he's really dead in her mind. So she's looking for any solution she can to bring him back -- Elena is basically mentally unstable, going a little crazy and everyone is trying to help.

ETonline: Obviously Elena still misses Jenna and Alaric, but I would imagine losing Jeremy has a much more profound and prolonged effect on her. True?

Dobrev: Losing Jeremy really, really, really changes Elena. Sometimes people recover from tragedy and sometimes they don't -- but it's a long journey for her. Elena's mourning peroid is much different than any I've ever seen depicted on TV before. She goes off the deep end and spirals downwards into a black hole of death and sadness and misery. I mean, your instinct is right when you asked if we'll see an Elena who embraces her vampire side to a different degree. It's an Elena we haven't seen before, and you'll be shocked, quite frankly. I was very surprised where the episodes take her because it's almost like she's a completely different person that you won't recognize to some degree.

5. Fergie Reveals: I'm Pregnant!

Congratulations are in order for Fergie and Josh Duhamel, as the couple announced this week that they're expecting their first child!

"Josh & Me & BABY makes three," she Tweeted, along with the hashtag #MyLovelyBabyBump

Fergie and Duhamel married on January 10, 2009, after five years of dating.

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Off-duty transit worker busted for drunk driving

An off-duty transit worker was busted for drunk driving in Brooklyn early today, authorities said

Cops spotted MTA employee Rosario Luis, 49, sleeping in a black 2010 Acura in Bedford Stuyvesant shortly before 1:30 a.m. today.

Half of his car was on the sidewalk at the corner of Nostrand Avenue and Vernon Avenue, police sources said.

The vehicle was still running, and sources said there was a strong alcohol odor on Luis.

He was taken into police custody, and a Breathalyzer test found his blood alcohol content was more than twice the legal limit of 0.08 percent, sources said.

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South Florida hospitals could lose $368 million from sequestration

A detailed survey shows that South Florida hospitals could lose $368 million over 10 years in federal budget cuts starting next Friday, if the sequestration program kicks in as scheduled.

The Florida Hospital Association, using data from the American Hospital Association, estimates that over the next decade, sequestration would cause Miami-Dade hospitals to lose $223.9 million and Broward facilities $144.4 million under the Congress-mandated budget cuts that hit virtually all federal programs unless Republicans and Democrats can work out a compromise.

The New York Times and other national news organizations are reporting that sequestration, unlike the New Year’s fiscal cliff, seems virtually certain to take place.

The law requires across-the-board spending cuts in domestic and defense programs, with certain exceptions. Because healthcare represents more than one in five dollars of the federal budget, it will be a huge target for cuts.

For hospitals and doctors, the major impact will be felt in Medicare cuts, which according to the budget law are limited to 2 percent of Medicare payments. Medicaid, food stamps and Social Security are exempted from cuts, according to the Bipartisan Policy Center.

The FHA study calculates that over 10 years, Jackson Memorial Hospital stands to lose $30.6 million, Mount Sinai Medical Center on Miami Beach $27.3 million, Holy Cross in Fort Lauderdale $23.8 million and Memorial Regional Hospital in Hollywood $21.4 million.

“The problem with sequestration is that it just makes broad cuts across the board,” said Linda Quick, president of the South Florida Hospital and Healthcare Association. “The Affordable Care Act is looking at all sorts of intelligent ways to reduce costs,” including coordinated care that will stop duplicated tests and reduce hospital readmissions. “But sequestration takes an ax, and that doesn’t make any sense.”

FierceHealthcare, which produces trade publications, says sequestration cuts over the next decade will include $591 million from prescription drug benefits for seniors, $318 million from the Food and Drug Administration, $2.5 billion from the National Institutes of Health, $490 million from the Centers for Disease Control and $365 million from Indian Health Services.

The National Association of Community Health Centers estimates that 900,000 of its patients nationwide could lose care because of the cuts. The group said the cuts were “penny wise and pound foolish” because they would mean less preventive care while more and sicker patients would end up in emergency rooms.

Like the fiscal cliff, Republicans and Democrats agreed on a sequestration strategy, with the idea that the drastic measure would force the two sides to reach agreement on more deliberative budget adjustments. That hasn’t happened.

The White House reports that the law will mean that nondefense programs will be cut by 5 percent, defense programs by 8 percent. But since the first year’s cuts must be done over seven months, that means in 2013, nondefense programs need to be cut by 9 percent, defense programs by 13 percent.

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Spring Breakers Threesome Scene

Vanessa Hudgens' new role in Spring Breakers is a far (very far) cry from her squeaky clean breakout role in High School Musical. In the latest, NSFW red-band trailer for the film, we get a sneak peek into the threesome that occurs between Hudgens, Pretty Little Liars star Ashley Benson and James Franco's characters -- and it rivals that infamous pool scene in the 1998 flick Wild Things.

A little over a minute into the trailer we see the stars triple kiss in a hotel pool as Franco's Kevin Federline-like character Alien calls the ladies his "soul mates."

RELATED PICS: Bikini-Clad Spring Breakers posters

But don't expect Hudgens, 24, in a role like this again. She told Glow magazine of the threesome, "It was very nerve-racking for me. I told my agent that I never want to do it ever again.”

So, how does this pool rendezvous come about? Spring Breakers, in theaters March 22, follows four college girls (Hudgens, Benson, Selena Gomez and Rachel Korine) who land in jail after robbing a restaurant in order to fund their spring break vacation. Bailed out by a drug and arms dealer (Franco), the girls end up doing his dirty work in exchange for their freedom ...from jail at least.

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