AUGUSTA – Central Maine Medical Center let go two high-level managers recently in an ongoing effort to cut hospital overhead, a spokesman said Wednesday.

Lower state Medicaid reimbursement rates coupled with a state-instituted spending cap on hospitals forced the actions, said Chuck Gill, vice president of marketing for the Lewiston hospital. Last year, state officials trimmed $58 million from Maine’s Medicaid budget, he said.

In all, CMMC faces a $3 million loss in the fiscal year that ends June 31, Gill said.

Clinical Director Don Lever, who worked at the hospital for more than 20 years, took early retirement, Gill said. A severance package is being worked out for Nursing Director John Fields, he said.

Gill called both men dedicated. He said their services will be missed.

The positions, which carried with them the status of vice president, will be eliminated, Gill said.

He declined to offer a number detailing how many other vice president positions remain at the hospital. “Some of us work for Central Maine Health Care,” CMMC’s parent, he said, while others work directly for the hospital.

He also declined to say just how much the hospital saved by the layoffs, but said it was “not a small number.”

“Less than 10” mid-level management positions also have been cut as an austerity measure, Gill said.

“Hospitals are facing tremendous financial pressures,” he said. “It’s very painful.”

Roughly 60 percent of CMMC’s budget is earmarked for wages and benefits, Gill said. While management has been scaled back, direct patient care has not.

“What we have not done is reduce the bedside” staff, he said.

In addition to personnel cuts, CMMC officials have scrutinized purchasing practices with an eye toward savings, Gill said.

Mary Mayhew, vice president for governmental affairs at the Maine Hospital Association said hospitals throughout the state have instituted cost-cutting measures in an effort to meet the state’s guidelines for limited spending increases.

She said she did not have firsthand knowledge of any hospital that had cut top-level staff to reach those goals.

Many, however, are finding creative ways to reduce their payrolls.

Franklin Memorial Hospital in Farmington, for example, has laid off the equivalent of two full-time employees, according to spokesman Dan Marois. But the hospital also is leaving some jobs vacant.

“We haven’t filled positions in some departments” when people leave, he said.

By using attrition, the hospital has been able to shift some hours where needed, he said.

A spokesman for St. Mary’s Regional Medical Center in Lewiston said Wednesday that hospital has not had layoffs and does not expect any.

“There have been no layoffs at all” over the past two years, said Sean Findlen, the hospital spokesman. “I know of none coming.”

Findlen also said financial officers at the hospital are not anticipating any losses in this fiscal year, which ends in December for St. Mary’s.

Gill said the situation facing hospitals isn’t likely to improve any time soon. He noted Medicaid reimbursements have fallen to 50 to 60 cents on the dollar “and that’s based on our costs.”

The number of Medicaid patients being seen at CMMC continues to increase, Gill added.

Dirigo, the state’s health care program that will soon kick in, will also “impact our costs,” he said.