Spenser Heaps, Deseret News
FILE - Intermountain Medical Center in Murray is pictured on Thursday, March 15, 2018.

SALT LAKE CITY — Intermountain Healthcare began holding meetings Thursday explaining structural changes to its medical leaders, but precisely how many of the hospital system's jobs will be affected remained unclear.

Following Thursday's meeting, medical leaders will go on to explain the changes to their employees over "several days" of meetings, said Intermountain spokesman Daron Cowley.

Amid a system-wide restructuring that began late last year and the outsourcing of 2,300 billing worker jobs to a new employer that is set to become official next month, Intermountain has also assigned 40 different work groups to examine how it can become more efficient and save costs by restructuring smaller rank-and-file parts of the organization.

Cowley explained that 29 of those groups were expected to have those changes announced in time for the meetings, while the other 11 are still sorting through the decision-making process.

Intermountain is Utah's largest employer and oversees 22 hospitals and 185 clinics.

Among all the changes, Intermountain leaders say it is difficult to know precisely how many employees will be displaced from their positions.

Intermountain CEO Marc Harrison last week said there would be further job losses in the organization constituting "an extremely small percentage of our overall work force." However, at the meetings starting Thursday and lasting over the next few days, "there will be no announcements of layoffs or outsourcing," according to a Monday email to employees that the company released to the Deseret News.

Despite the apparent lack of major announcements at the restructuring meetings, Harrison has said they would represent an important step toward stability, calling them "an opportunity to bring people together and share what the vision looks like, so people can settle down and get to work."

But it remains unclear when further shakeups, which Harrison had alluded to in last week's interview with the Deseret News, may result in additional employees being removed from their current position in some capacity. The number of workers who could be directly affected by future changes is also unknown.

"Some jobs are being affected or may be eliminated with this restructuring," Rob Allen, chief operating officer, said in a prepared statement. "Where possible, we are working to place employees in other jobs within Intermountain. Because the process is not yet complete, we are unable to provide a specific number of displaced employees at this time."

Cowley was asked whether meetings about restructuring would include announcements requiring certain employees to apply for new jobs within the organization.

"No, I don't believe that is the case. I don't believe there will be any of that," Cowley said Wednesday.

Cowley was reluctant to give further details about affected jobs aside from what Intermountain has already said publicly.

"We're not going to get down to specifics until we get a chance to tell them to our own employees first," he said.

Cowley insisted that the staff meetings in the near term would be "strictly about the (new) structure that these groups within Intermountain have already defined.

"They're going to be just going over how the structure works and how it all works together," Cowley said. "It actually goes back to things that were announced last October."

Cowley was referring to last year's changes in which Intermountain announced it was scrapping its "geographically defined administrative regions" and installing in their place two main reporting structures — a Community Care Group and a Specialty Care Group.

At the time, a handful of administrators' jobs were affected.

Many more employees — 2,300, Intermountain said — were affected when the organization announced in January it would be outsourcing billing and scheduling staff to a revenue cycle company called R1 RCM, effective April 8.

The hospital system said affected employees would stay employed with R1 if they elected to do so, and would retain their current salaries as well as have their tenure at Intermountain credited to them. As of earlier this month, 94 percent of employees had accepted their offers to make their switch, with 3 percent declining the offer and another 3 percent having not yet responded.

However, employee benefits are not the same at R1, which does not offer a pension, and one worker said they and dozens of their colleagues in St. George were told they must relocate to West Valley City by September.

Harrison said last week that moving some employees to R1 prevented "hundreds, if not a thousand" people from being laid off.

The Deseret News recently spoke with 15 current or former employees of Intermountain who described low morale at the organization as workers brace for the prospect of more changes, including an executive who left because he felt trust between staff members and their leaders had "been destroyed."

An Intermountain construction employee who did not wish to be named said Thursday that he and a few dozen of his colleagues were told last week that the company is largely "getting out of the construction business." The positions of at least 30 Intermountain construction workers will be dissolved, the employee said, though those affected are invited to apply for six positions.

"We were a little surprised," the source said, because construction employees were told in-house construction workers were a more inexpensive option than contracting out projects.

The worker said he and his co-workers were dissatisfied with the answers they received about details on severance packages and how unfinished construction projects should be handled as part of the transition.

"The guys who were making the announcement to us didn't have answers," the employee said.

The source said workers whose jobs are dissolved will be out of work by early May.

"It's been a good job for me, the people around me," he said. "To get the benefits you get (with Intermountain) are tough to replace."

Cowley declined to provide a specific response to the job displacement details offered by the employee.

The Monday email sent to employees states that the upcoming meetings would address "physician and nurse leadership," "how … speciality clinical care will be organized and led," "how pediatric care will be organized and implemented," and "the new virtual hospital plans," among other things.

"We aren't finished with this journey yet and there are still many details to work out, but we've reached an important milestone," Allen is quoted as saying in that email. "The reporting structures and collaboration processes will look quite a bit different from what we've done in the past, but I think the changes will help us ensure consistently high-quality care across the system."

But Sen. Jim Dabakis, D-Salt Lake City, who serves on the Senate Health and Human Services Committee, said Thursday that "the people that run (Intermountain) have a lot to answer for" regarding their significant restructuring.

"They owe it to the public. … Tell us what the facts are," Dabakis told the Deseret News.

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Dabakis said that, due to the immense influence of Intermountain on Utah's workforce, "we ought to be having a community discussion" about the effects of its changes, which he said isn't possible because of a lack of easily accessible information for employees, Intermountain customers, or the public.

Allen offered a response to Dabakis' criticisms, saying Intermountain acknowledges the changes have been difficult for some within the organization, but added that they address improvements the hospital and clinic system needs.

"We understand this reorganization process has been challenging for some of our employees," Allen said in a statement. "After the process is completed, we believe it will help us provide even better service and care to our patients and the community."