Inova Health System has cut 13 percent of its management jobs to reduce costs, a spokesman for the Northern Virginia company said this week. Inova, which operates five hospitals and is one of the Washington region’s largest health systems, said it cut 117 senior and mid-level jobs across all its hospitals. At the four community hospitals — Fair Oaks, Alexandria, Loudoun and Mount Vernon — the leadership teams were restructured to eliminate the position of chief operating officer. There were no cuts to nurses or doctors directly involved in patient care, said spokesman Tony Raker.

Of the 117 positions eliminated, 84 were the result of attrition and 33 were through layoffs. Employees were told Monday. The cost reductions were in response to anticipated health-care changes, including continuing reductions in Medicare compensation, Raker said.