Many large health system layoffs in 2026 feature a common theme: Leadership is cutting corporate and administrative support roles while protecting positions that focus on patient care. It’s a pattern that shows how organizations are deciding what to cut as costs rise and federal policy changes reshape the industry.
Below is how four systems drew the line:
Kaiser Permanente. Oakland, Calif.-based Kaiser Permanente is eliminating 147 business and administrative positions across 16 locations in California counties including Los Angeles, Orange, Riverside, Alameda and San Diego, effective Nov. 20. San Diego will see the biggest impact, with 72 positions cut at regional administrative offices. Kaiser said the affected positions do not include direct patient care responsibilities.
HCA Healthcare. Nashville, Tenn.-based HCA eliminated a “small percentage” of positions across its corporate office and support functions. A spokesperson for the system did not specify how many positions were affected. The 190-hospital system employs more than 320,000 people. The cuts come after a July downward revision to HCA’s 2026 guidance, which lowered its net income outlook to between $6.3 billion and $6.7 billion.
Wellstar Health System. The Marietta, Ga.-based system shared plans in late July to cut 761 roles, about 2% of its more than 35,000-employee workforce. The reductions hit corporate and shared services functions, including administrative roles in its Wellstar Medical Group, but did not affect front-line care team roles.
“These changes will help us simplify our structure, clarify roles, strengthen accountability and move decision-making closer to the people who care for patients, while positioning Wellstar for continued long-term sustainable growth,” a spokesperson for the system told Becker’s. “Our mission has not changed, and our patients will continue to receive the same compassionate, high-quality care they expect from Wellstar.”
Baystate Health. The Springfield, Mass.-based system laid off employees the week of June 15 to “right-size” its team, citing a $60 million budget shortfall through late May. Baystate did not reveal how many workers were affected, but said it is purposely trimming administrative layers, shifting resources to caregivers and continuing to recruit front-line clinical staff. The Massachusetts Nurses Association said the layoffs reached employees across 22 departments, including dozens in information technology.
The other side of the ledger. Even while administrative ranks thin, systems are still spending to retain workers. Becker’s has reported that 49 hospitals and health systems have announced plans to raise workers’ pay since December 2025. For example, Hartford (Conn.) HealthCare shared in late September that it will raise its minimum wage to $20 an hour Dec. 27, affecting about 4,000 employees. An additional 4,000 employees will receive pay adjustments to address wage compression resulting from the increase.
