MetroWest Medical Center, which operates hospitals in Natick and Framingham, is reducing its staff by about 50 positions, including about 30 layoffs, according to hospital CEO Andrei Soran.
Declining patient volume combined with a need to keep pricing competitive led to the decision, according to Soran. The cuts will impact only a small portion of the hospital's 2,500 workers at Framingham Union Hospital and Leonard Morse Hospital in Natick, but not doctors or nurses.
While about 30 workers have lost their jobs, the hospital has cut another about 20 positions through attrition and not filling vacancies.
"Lower reimbursements combined with lower volume leads to a necessity of cutting costs," Soran said.
While Soran would not discuss specifics of how much patient volume has dropped off, he said it is an industry-wide trend.
Dennis Irish, spokesperson for Vanguard Health Systems, which owns MetroWest Medical, said the system's other hospital in the region, Worcester's Saint Vincent's Hospital, has also seen a drop in patients in the last few years, but Irish said there are no plans for cutbacks there.
"It varies month to month, but there has been a decline in the volume of activity - not to a point of any personnel actions being required though," he said.
A decline in the number of patients comes at a time when more people than ever in Massachusetts and around the country have health care. Massachusetts health care reform - which was implemented four years ago - requires all residents to have health insurance. Federal health care reform passed earlier this year carries a similar mandate.
But just because more people have health insurance doesn't necessarily equate to more people using hospital services, according to Soran.
The recession has caused changes in health insurance payment plans, so for example, Soran said it's not uncommon for people to have higher deductibles and copays. That, he said, can drive down use.
And Soran isn't expecting a major turnaround in patient volume any time soon. New costs for health-care payments are unlikely to change dramatically. Plus, he said new forms of hospital care are emphasizing patients being more personally responsible for their health, which could further cut into patient volume. Overall, Soran said he does not expect patient volume to return to pre-recession levels even if the economy does fully recover.
Despite it all, Soran is still optimistic about the future of MetroWest Medical Center. For example, the hospital recently signed an expanded partnership with Tufts Medical Center. The agreement will allow the two hospital systems to share services, refer patients between the two organizations and allow MetroWest Medical Center doctors to join the Tufts physician care organization.
According to Soran, those moves are the building blocks for the MetroWest Medical to create an accountable care organization, which is a new payment model that focuses on controlling cost also referred to as a global payment model. Soran said MetroWest Medical and Tufts officials are exploring the possibilities of how such a system could be implemented.