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Bring in the relationship experts to label this one. St. Vincent Health and Monroe Hospital in Bloomington have pulled back from their “strategic alignment”—which had St. Vincent managing Monroe’s operations but was a step short of a merger—and will instead settle for a clinical partnership for cardiology, orthopedic and critical care services. Longtime St. Vincent executive Joe Roche, who had led the attempt to integrate the systems, will now become the CEO of Monroe Hospital, starting Monday. “We are appreciative for the opportunity to have explored integration options with Monroe Hospital, and to continue our clinical partnerships to serve the residents of Bloomington and surrounding communities,” Ian Worden, interim CEO of St. Vincent Health, said in a prepared statement. The Bloomington market is dominated by St. Vincent’s archrival, Indianapolis-based Indiana University Health, which owns IU Health Bloomington Hospital there. Monroe, which boasts 32 inpatient beds, was having financial difficulties and had been looking at a partnership with Franciscan St. Francis Health before it struck its deal with St. Vincent last year.

Less-than-expected profit in emerging markets and a decline in the Japanese yen could make it difficult for Eli Lilly and Co. to meet a goal of at least $20 billion in revenue next year, the Indianapolis-based drugmaker said Thursday. But the company said it would cut costs, if necessary, to reach its other 2014 goals of $3 billion in profit and $4 billion in operating cash flow. “I am confident in our outlook to return to a period of growth and expanding margins,” Chief Financial Officer Derica Rice said in a statement. Lilly will also take a hit from Obamacare. The 2010 law, known as the Patient Protection and Affordable Care Act, required drugmakers to give larger rebates to federally funded health plans and will add a tax onto all U.S. sales of prescription drugs. Those impacts, as well as Obamacare's elimination of a tax benefit for retiree drug coverage, will cost Lilly about $500 million this year. But Lilly might also see its sales hampered by the Obamacare exchanges, the online marketplaces that started Tuesday in all 50 states. That's because health insurers, in an attempt to keep premiums low, are creating narrower formularies that exclude some drugs from coverage. Similarly, insurers are creating "narrow networks" that offer coverage for fewer doctors and hospitals.

Indiana University Health plans to eliminate 935 workers in Indianapolis, Carmel, Fishers and Muncie, according to documents filed by the hospital system with the state. The cuts will affect 746 in Indianapolis at Methodist Hospital, Riley Hospital for Children, University Hospital and IU Health Physicians. In Carmel, 67 will be cut at IU Health North Hospital. Two will be trimmed at Saxony Hospital in Fishers. In Muncie, IU Health plans 120 cuts at Ball Memorial Hospital. IU Health employs about 36,000 statewide. It says it's looking to save $1 billion in costs over the next four years. The Indianapolis-based system said last month it must make the cuts because fewer patients have been coming to hospitals, and payment rates for its services have been declining.