The company's restructuring charges were originally necessitated primarily by continued declines in Medicare and Medicaid reimbursement by the U.S. government, as well as similar healthcare reimbursement pressures abroad, which negatively affect the company's customers (e.g. home health care providers) and continued pricing pressures faced by the company due to the outsourcing by competitors to lower cost locations. Restructuring decisions were also the result of reduced profitability in North America and Asia Pacific. In addition, as a result of the company's transformation strategy, additional restructuring actions were implemented in 2017 and have continued into 2020.

For the six months ended June 30, 2020, charges totaled $3,077,000 which were related to North America of $719,000, Europe of $2,240,000 and All Other of $118,000. In North America and All Other, costs were incurred related to severance. The European charges were for severance costs of $1,894,000 and contract terminations of $346,000. Payments for the six months ended June 30, 2020 were $4,086,000 and the cash payments were funded with the company's cash on hand. The 2020 charges are expected to be paid out within twelve months.

For the six months ended June 30, 2019, charges totaled $2,013,000 which were related to North America of

$1,208,000, Europe of $640,000 and All Other of $165,000. In North America, costs were incurred related to severance of $1,164,000 and contract terminations of $44,000. The European and All Other charges were for severance costs. Payments for the six months ended June 30, 2019 were $2,113,000 and the cash payments were funded with company's cash on hand. Most of the 2019 charges have been paid out.

There have been no material changes in accrued balances related to the charges, either as a result of revisions to the plans or changes in estimates. In addition, the savings anticipated as a result of the company's restructuring plans have been or are expected to be achieved, primarily resulting in reduced salary and benefit costs principally impacting Selling, General and Administrative expenses, and to a lesser extent, Costs of Products Sold. To date, the company's liquidity has not been materially impacted by the restructuring plans. Please refer to Charges Related to Restructuring Activities of company's Annual Report on Form 10-K for the period ending December 31, 2019 for disclosure of restructuring activity prior to 2020.

A progression by reporting segment of the accruals recorded as a result of the restructuring for the six months ended June 30, 2020 is as follows (in thousands):


	Severance		Contract Terminations		Total






























































































































































































December 31, 2019 Balances
North America	$	211	$	—	$	211
Europe	6,406		4		6,410
All Other	406		—		406
Total	7,023		4		7,027
Charges
North America	691		—		691
Europe	592		73		665
All Other	36		—		36
Total	1,319		73		1,392
Payments
North America	(562)		—		(562)
Europe	(959)		(73)		(1,032)
All Other	(276)		—		(276)
Total	(1,797)		(73)		(1,870)
March 31, 2020 Balances
North America	340		—		340
Europe	6,039		4		6,043
All Other	166		—		166
Total	$	6,545	$	4	$	6,549



Charges
North America	$	28	$	—	$	28
Europe	1,302		273		1,575
All Other	82		—		82
Total	1,412		273		1,685
Payments
North America	(265)		—		(265)
Europe	(1,596)		(273)		(1,869)
All Other	(82)		—		(82)
Total	(1,943)		(273)		(2,216)
June 30, 2020 Balances
North America	103		—		103
Europe	5,745		4		5,749
All Other	166		—		166
Total	$	6,014	$	4	$	6,018