Many hospitals across Georgia that used to be flush with cash are now struggling, as the economy and changes in health care chip away at hospitals’ bottom lines.

The evidence of a widespread financial squeeze was obvious last week when Piedmont Hospital, historically one of the strongest financial performers in the state, joined Grady Memorial Hospital, Atlanta’s massive charity care provider, in announcing that a bleak financial outlook required layoffs.

“We’re certainly reaching a breaking point,” said Kevin Bloye, a spokesman for the Georgia Hospital Association.

It’s unclear whether the current cuts will lead to patients waiting for help in a hospital bed or emergency room, but it’s certain that hospitals will have to make significant changes in the coming years because of market forces and the national health care overhaul.

In Saturday's newspaper, the AJC takes a deep look at what is driving financial difficulties in the metro hospital market. It's a story you'll get only by picking up a copy of The Atlanta Journal-Constitution or logging on to the paper's iPad app . Subscribe today.