Three years ago, Henry Ford Health System began to overhaul how its doctors and nurses care for patients outside the Detroit-based system’s six hospitals. Now it must face the economic strains of its own success, as fewer patients turn up to fill hospital beds.

Since January, the number of patients admitted to Henry Ford hospitals has declined 6%, compared with a 2.5% inpatient decline overall in Southeast Michigan; Medicare patients who returned to the hospital within 30 days after discharge fell 19% during the same period. A boom in births has offset fewer patients who need cardiac, pulmonary or kidney care—but only partially.

“We think it’s beginning to have an effect,” Dr. William Conway, Henry Ford’s executive vice president and chief quality officer, said of the system’s broad strategy to prevent hospitalizations. “These things really are working.” To read more click here.