YANKTON, S.D.(WNAX)- Avera Health announced in September that they would lay off some employees and cut hours in a cost control move.

Doug Ekeren, President of Avera Sacred Heart Hospital in Yankton, says costs are rising much faster than revenues.

Ekeren says it’s a difficult balance on services and employees.

Ekeren says they are looking at alternative services and providers.

Avera Sacred Heart discontinued a cardiac rehab program.

Most of the job cuts were in administration and support and not direct medical care.