MINNEAPOLIS — Hennepin County Medical Center in downtown Minneapolis is planning to reduce its workforce by as much as 4 percent next year.

The hospital plans to eliminate up to 275 full-time positions to balance the budget and keep the opening of a $220 million ambulatory and outpatient surgery center on schedule for 2018.

The hospital’s workforce totals about 6,800 people, according to Minnesota Public Radio. Hospital leaders haven’t said what types of workers are at risk for layoffs, though Chief Executive Jon Pryor told county commissioners that “everything’s on the table.”

Some jobs might be eliminated through attrition rather than through layoffs, according to Chief Financial Officer Derrick Hollings.

“At the end of the process, it is not our anticipation that the actual pink slips or layoffs will be 275,” he said.

The workforce reduction will save the hospital $28 million. Proposed wage freezes would save another $3 million. County commissioners are to vote on the hospital budget Tuesday.

Even though patient activity has increased, hospital leaders have bemoaned the high share of patients who are covered by the state’s Medical Assistance program. They contend the state program for the poor and disabled reimburses hospitals and clinics below the cost of caring for patients.

Construction of the ambulatory center is expected to draw a broader mix of patients, including those with private insurance, which could help stabilize the hospital’s finances.

HCMC also imposed layoffs in 2009, when about 200 jobs were cut and the hospital instituted a pay freeze.