Valley Medical Center in Renton has eliminated 60 positions – a little more than 1 percent of its workforce – because of recent changes in health care.

The center has seen a dramatic shift in patient volume since August, according to Liz Nolan, vice president of Marketing, Outreach &Wellness at VMC.

“Rapidly changing volumes caused significant turbulence in our budget, and just as our patient volumes exploded, Medicare became our top insurance payer,” said Nolan, adding that Medicare pays Valley “just cents on the dollar, below our costs.”

The current shift in health care is not only affecting Valley, but it is also impacting many health systems throughout the state and country, Nolan said.

Local and federal government actions also could weigh in on Valley and other health care systems. Nolan said state legislators in Olympia are considering eliminating hospital-based billing from off-campus locations like Valley’s urgent care facilities. If this were to happen, she said, it would negatively impact Valley by $3.5 million annually.

At the federal level, the replacement of the Affordable Care Act could likely lower coverage available to members of the community. Nolan 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. VMC said it 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 the office of patient experience, as well as close the Newcastle Urgent Care, restructure the assistant nurse manager positions, reorganize Patient Care Services Education, discontinue the Break Relief Program and consolidate 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.”

Staff throughout the company was given the chance to make suggestions to reduce costs, she added. They have received more than 700 suggestions and have tried implementing any that may have a possible material impact.

Valley is focusing efforts to avoid impacting direct clinical care, Nolan said. The center will continue to monitor its financial situation and look for opportunities to make shifts in service and for chances for new revenue potential, she said.

“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,” Nolan 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 that’s being built on 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.”