SPRINGFIELD — Baystate Health will lay off 24 employees, cut hours for another 17 workers and not fill 45 open positions as a way of closing a $22 million system-wide budget shortfall.

The jobs are all based in Springfield and almost entirely at the flagship Baystate Medical Center operation, spokesman Ben Craft said Thursday. The eliminated jobs do not include bedside nurses nor do they include doctors. The jobs do include clinical support and administrative jobs and 10 management positions, Craft said.

Those to be laid off were given notice that their jobs will end in 30 days.

Without the cuts, Baystate would have had trouble making its projected operating margin for the year, money used to keep up with capital expenses for buildings, programs and equipment, Craft said.

Baystate blamed the shortfall on the difference between what it the government pays it to care for the poor and what that care costs.

Baystate Medical Center is one of the largest providers of Medicaid services in Massachusetts, according to a news release, and provided more than $112 million in unreimbursed care in 2014.

Nancy Shendell-Falik, chief operating officer of Baystate Medical Center, said in the release, "We are committed to providing these services in line with our charitable mission; unfortunately the reimbursements we receive for providing Medicaid services are well short of our costs, typically between 70 and 80 cents on the dollar. We take any decision to end any person's employment very seriously, and we regret the necessity of it. We will do everything possible to help those affected find new opportunities, either within or outside Baystate Health."

According to the release, affected employees will receive severance pay and extension of benefits in accordance with their tenure of service and job placement assistance.

Baystate Health has a total of 11,500 employees at Baystate Medical Center, Baystate Mary Lane in Ware, Baystate Franklin in Greenfield, Baystate Wing in Palmer and other assorted operations. Of those, 6,100 work at Baystate Medical Center in Springfield, the 761-bed hospital that also serves as Western Massachusetts' only Level 1 Trauma Center and has the second-busiest emergency room in all of Massachusetts.

Baystate is already trying to save money through its supply chain, process improvement and energy efficiency.

Related:

Baystate layoffs: Hospitals across Western Massachusetts adjust in a time of change