KentuckyOneHealth, which employs around 15,000 people and includes Lexington's St. Joseph's Hospital and St. Joseph East, may need to cut its workforce due to a $218 million debt.
The company's website said that "costs are greater than revenue" and the system needs to gain the $218 million by the end of fiscal 2015.
The new health-care reform law is partly to blame, according to Ruth Brinkley, president and CEO of KentuckyOneHealth.
"Unprecedented changes in reimbursement and a rising cost of delivering care" are also playing a role, according to a company statement.
Brinkley said alongside possible employee cuts, the system would also have to merge some of its services.
She said the company is also looking at ways to reorganize its programs, as well as new ways to set up its facilities and how to manage and improve their current services.