FARGO - Officials of the largest health care system in the state say it's losing money, forcing it to lay off about 90 workers, close a clinic southwest of Fargo and make other cuts.

Besides the layoffs, about 90 employees at MeritCare Health System will have their hours reduced and about 120 open positions will not be filled, company officials said at a news conference Thursday. The clinic to be closed is in LaMoure, about 100 miles southwest of Fargo.

"It's disgusting, almost. Not almost; it is," Dr. Roger Gilbertson, MeritCare president and chief executive officer, said in discussing the cuts.

MeritCare employs about 7,500 people at hospitals and clinics in eastern North Dakota and western Minnesota. The cuts represent about 1.2 percent of the company's work force and about $9.2 million in salaries and benefits, Gilbertson said.

Meritcare has seen an increase in the number of patients, but work force costs have outpaced that growth, Gilbertson said. Company officials said earlier that cuts were planned, but gave more details Thursday.

"The good news is - and it's not good news when you're losing money - but it's good news that our volume is very good," Gilbertson said. "We've grown forever, to 8, 9 percent per year. That's continued this year, as well."

Most of the workers affected by the cuts are in professional and technical positions. The changes will affect about 50 nursing positions but no doctors, company officials said.

"We tried to focus very hard in areas not involved in direct hands-on patient care," said Dr. Bruce Pitts, executive vice president of clinical services.

"We're actually in a recruiting mode when it comes to doctors. We're approaching a significant shortage in physicians," Pitts said.

Gilbertson said expected Medicare cuts of 10.6 percent to physician payments and an estimated 2.5 percent reduction in reimbursements from Blue Cross Blue Shield of North Dakota are contributing factors to the company's financial situation. "Those are very staggering kinds of things," he said.

Later, he said the work force cuts were coming without the reductions in payments.

The LaMoure clinic had been open all day Wednesday and half-days the rest of the week. Two office employees will lose their jobs and have agreed to severance packages.

Clinics in Twin Valley and Ulen, Minn., will be open fewer days as part of the cost-saving plan, officials said.