Due to recent changes in healthcare Valley Medical Center has eliminated 60 positions, which is just a little more than 1 percent of the workforce.

Since August 2016, Valley Medical Center has seen a dramatic shift in patient volume, Liz Nolan, vice president of Marketing, Outreach &Wellness, said in an email.

The two shifts Valley has seen, she said, are with the number of patients as well as the type of insurance patients use.

“Rapidly changing volumes caused significant turbulence in our budget and just as our patient volumes exploded, Medicare became our top insurance payer,” Nolan said.

She added Medicare pays Valley “just cents on the dollar, below our costs.”

This current shift in healthcare is not only affecting Valley, but it is also affecting many health systems across the state and the country.

Two other factors that could impact Valley and other healthcare systems is the local and federal government.

Nolan said state legislators in Olympia are currently considering eliminating hospital-based billing from off-campus locations like Valley’s urgent cares.

She said if this was to happen it could negatively impact Valley by $3.5 million annually.

At the federal level, the replacement of the Affordable Care Act could likely lower the coverage available to members of the community. She said this could also negatively impact Valley by millions of dollars annually.

Nolan said Valley has done a number of things to address these changes since August, but could not avoid a workforce reduction.

Those employees who were affected by the reduction are still in their decision period, she said. Valley believes 42 of the 60 employees will likely elect to take another position at Valley rather than leaving altogether.

Valley has also implemented a voluntary early retirement and voluntary separation incentive program for employees.

The chief operating officer position and two vice president positions were eliminated. Valley will also streamline Information Technology, Risk Management, Patient Financial Services, Process Improvement, Peri-Op, Clinic Billing, Finance, Supply Chain, Facilities, Occupational Health, Wound Care, Oncology, Marketing, Clinic Network Administration and Office of the Patient Experience, as well as close the Newcastle Urgent Care, restructuring the assistant nurse manager positions, reorganizing Patient Care Services Education, discontinuing the Break Relief Program and consolidating clinic-based Imaging Services.

Aside from reducing the workforce, Nolan said Valley’s management team “has been aggressively managing costs related to purchased services, pharmaceuticals, overtime and premium pay, limited hiring to patient care and essential positions, implemented benefit changes and wellness programming.”

She added staff across the company were given the chance to make suggestions to cut back costs. They have received more than 700 suggestions and have tried implementing any that may have a possible material impact.

Because quality of care and patient safety is a top priority for Valley, she said they are focusing their efforts to avoid impacting direct clinical care.

Looking ahead, Nolan added Valley continues to monitor its financial situation and look for opportunities to make shifts in service and for chances for new revenue potential.

“It’s also vitally important that we don’t lose sight of the future, so we have identified opportunities for strategic growth and increased access to care that will serve us and our community well into the future,” she said.

A key to success in Valley’s future is “to remain nimble, to monitor the impact of all the changes we’ve made and continue to make and re-adjust,” she said.

Valley is still continuing to grow services including the new cancer center being built at the medical center campus.

“Despite how tumultuous the past few months have been,” Nolan said. “Our future is bright and our commitment to serving patients and their families is as strong as ever.”