FRESNO, Calif.—The second-largest hospital in Fresno plans to lay off 75 workers in response to what hospital administrators described as continued economic hurdles, a dwindling number of patients and lower government reimbursements.

The Fresno Bee reports (http://bit.ly/10T0XMO) Saint Agnes Medical Center began notifying affected employees on Wednesday, the third staff reduction in the last four years at the hospital owned by Michigan-based Trinity Health.

Hospital spokeswoman Kelley Sanchez did not clarify which members of the hospital's staff of 2,724 were impacted.

Other area hospitals also have cut staff in recent years. Community Medical Centers laid off 150 office and support workers two years ago, also citing falling government payments to its hospitals in Fresno and Clovis.

"Across California, we hear of hospitals readjusting and resizing almost weekly," said Lynne Ashbeck, regional vice president of the Hospital Council of Northern and Central California. "It's just a reality of a changing health care market and we're probably going to see more of this before we get through health care reform."

Jan Emerson-Shea, vice president of the California Hospital Association, said some hospitals are reducing staff to offset revenue declines, in part because Medicare and Medi-Cal, the government insurance programs for the elderly and the poor, don't cover the cost of care. California hospitals were underpaid $9.5 billion by the two programs in 2011, she said.

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Information from: The Fresno Bee, http://www.fresnobee.com