Changes are in full effect for Ballad Health.

The health system announced Tuesday that it is in the process of eliminating roughly 150 currently occupied positions within the health system — citing duplicative jobs following the merger of Mountain States and Wellmont that range from senior-level executives to middle management and front-line team members. An additional 49 positions have already been eliminated through attrition but will not affect anyone within the system.

Ballad Health CEO and Chairman Alan Levine held a press conference Tuesday afternoon from the health system’s corporate office in Johnson City to address the announcement.

According to Levine, the elimination of jobs is primarily affecting administrative and management roles. Sycamore Shoals Hospital, which is based in Elizabethton and under the Ballad Health umbrella, will not be affected from the decision, Levine said.

“This is one of the benefits of the COPA,” he said. “Not one rural hospital is being affected from this decision.”

Information obtained from the health system Tuesday showed that the combined operating income for Wellmont and Mountain States fell from a  $25.1 million operating gain in the first six months of fiscal year 2017 to an operating loss of $2.6 million in the first six months of the 2018 fiscal year.

“Ballad Health is experiencing the same external pressures that hospitals throughout the nation are facing.  Specifically, we are seeing increased supply and drug costs, increased cost of labor due to shortages in certain positions, federal policy changes driving down reimbursement, and the continued shift from inpatient to outpatient services. Each of these issues had a profound effect on the financial performance of both Wellmont and Mountain States leading up to the merger, and they continue to affect us as Ballad Health,” the health system said in a statement issued Tuesday.

Another reason cited for the job shortage is the non-growth of population within Northeast Tennessee and Southwest Virginia, Levine said. The CEO indicated that Ballad will be willing to work with entities within both regions to assist with population growth.

“When we proposed the merger, we were clear about the problems we were going to encounter,” Levine said. “‘We’re not projecting any population growth. We’re seeing projected declines. If you don’t invest in the growth within the region, you’ll have stories like this.”

According to Levine, the announcement is a bit lower than the anticipated 250 jobs that would have been reportedly terminated. That number was being passed around during merger talks in September. Along with the elimination of duplicative jobs, Levine added that attrition has helped the system eliminate jobs without affecting any other employees.

The health system will be working with employees impacted by the decision. Levine noted that Ballad Health is actively recruiting for the more than 700 open positions within the system, with more than half of the positions being in nursing.

“The shift from duplicative administrative positions to the continued hiring of needed clinical positions is indicative of Ballad Health’s effort to reduce the overall cost of health care,” Ballad said in statement. Levine added that population growth for individuals is 65 years and older, which is why the system is looking to expand its role with the population by having additional clinical facilities in Johnson City.

Levine added the system is going to work with employees affected with compensation packages and that they can be eligible for other open positions within the system.