The leader of Indiana University Health Bloomington stated Thursday that it might have to eliminate positions in the future, failing to rule out local layoffs on a day IU Health announced hundreds of cuts in other parts of the state.

IU Health will cut 800 positions at hospitals in Indianapolis, Carmel, Fishers, Muncie and Tipton. The move comes as the health system tries to find $1 billion in cost savings over five years. It said it’s caught in a national trend of fewer admissions and dropping federal and private insurance reimbursements.

IU Health Bloomington is also searching for cost savings and ways to become efficient, according to an email statement from Mark Moore, its president and CEO.

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