Thirteen managers have been laid off at the combined Excela Health and Butler Health System.

Melissa Forster, marketing and communications specialist at BHS, said Thursday the positions that were eliminated originated in both Butler Health System and Excela Health.

The two health systems merged earlier this year.

“The positions were derived from various support functions,” Forster said in an email. “They were not ones related to direct patient care.”

She did not answer questions on the amount the health system will save through the layoffs, whether the laid-off managers received a severance package, when the layoffs took effect, or any of the managers’ titles.

“This action represents an aspect of our initiatives to reduce expenses in light of the economic pressure our industry and our system are facing,” Forster said.

A letter to employees acquired by the Butler Eagle on Feb. 28 revealed that significant financial challenges in the health system necessitated the need for a “significant expense reduction plan.”

In the letter, Ken DeFurio, Butler Health System CEO, said to ensure long-term success, the health system “must substantially reduce our operational costs.”

He listed the ongoing effects of the coronavirus pandemic, staff shortages, inflation, cost increases, declines in reimbursement rates for health systems, erosion of the stock market and other factors as reasons for the health system's financial problems.

“(They) all contribute to losses from operations that are daunting,” DeFurio told employees in the letter.

It is not known what, if any, additional steps will be taken to reduce expenses within the health system.