WATERLOO - Wheaton Franciscan Healthcare-Iowa will eliminate about 80 full-time, nonclinical positions over the next year because of worsening national economic conditions.

The health care provider will immediately lay off 15 people who work at hospitals and clinics in Waterloo, Cedar Falls and Oelwein.

The remaining cuts will come via retirements, voluntary layoffs and job restructuring in an organization that might fill 300 positions per year, said Jack Dusenbery, WFHI president and chief executive officer.

Dusenbery said he does not expect additional layoffs will be necessary, unless the economy takes another dramatic turn south.

"We have been working diligently on our cost structure in light of the national economic recession and local increase in un-reimbursed care," said Dusenbery. "The unfortunate aspect of our recent expense management efforts is the need to reduce our work force."

Health care is one of the most stable industries in a recession because of constant demand for its essential services. However, Dusenbery said the ability to adjust the organization's budget, which approaches $700 million per year, is constrained by the burgeoning level of unreimbursed health care to the elderly.

"That is just growing by leaps and bounds year over year," he said.

Because so many of a hospital's patients are on fixed price plans - whether through private or public health care - it cannot increase revenue by raising prices, Dusenbery said.

That is a particular problem in Iowa because hospitals have long complained government rates do not adequately cover costs. The state has one of the lowest Medicare reimbursement rates in the nation.

Last year, the organization reported $23 million in unreimbursed care to the elderly, which is the shortfall created when patient payments are below the cost of treating them through Medicare.

In contrast, three years ago Wheaton Franciscan reported $8.9 million in unreimbursed care to the elderly.

Wheaton Franciscan Healthcare employs 3,100 people in Northeast Iowa. Its network includes Covenant Medical Center in Waterloo; Sartori Memorial Hospital in Cedar Falls; Mercy Hospital in Oelwein and Covenant Clinic.

Contact Jens Manuel Krogstad at (319) 291-1580 or jens.krogstad@wcfcourier.com.