Kaiser Permanente Hawaii has offered buyouts to an undisclosed number of its 850-member nursing workforce in an effort to redesign the way health care is delivered and adjust staffing levels in an increasingly competitive market.

The state’s largest health maintenance organization recently sent voluntary buyout letters to nurses in departments that the company wouldn’t disclose.

"It’s a voluntary program. We put it out to a wide range of people," said Kaiser spokeswoman Laura Lott, adding that workers in targeted departments aren’t being forced to leave the organization.

Company officials would not disclose how many nurses had received the letter. The Hawaii Nurses Association said it did not know.

"We’re really trying to make sure we have the right people in the right positions to best serve the needs of our patients," Lott said. "We have to make sure that we have the right workforce to be nimble in the marketplace."

Lott wouldn’t say whether the move is intended to cut costs or reduce the workforce.

But hospitals sometimes offer so-called "voluntary separation incentive programs" to avoid or reduce layoffs, or to achieve permanent budget reductions.

When asked whether Kaiser would hire as many people as those who accept the buyouts, she said: "I can’t say it’s 1 for 1."

Kaiser, which has about 4,400 employees at the Moanalua Medical Center and Clinic and 18 clinics statewide, eliminated 35 union and management positions last month in an effort to streamline operations, but said it is still seeking to fill more than 125 vacant positions.

"We’ve filled over 300 positions in patient care areas alone," Lott added.

The company reported a $200,000 loss in the second quarter, its most recent earnings report, reversing gains of $2.8 million in the year-earlier period. It is scheduled to release its third-quarter financial statement on Friday.

Joan Craft, president of the Hawaii Nurses Association Local 50, which represents roughly 750 Kaiser nurses, said the voluntary separation agreement program offers the workers a "generous package," but wouldn’t elaborate on details of the buyout.

"It’s voluntary, that’s the big thing," she said. "This is the first time it’s been offered in Hawaii. It’s something that’s been offered in other Kaiser regions. Because of the economy, many employers are looking at ways to be more efficient. I don’t think Kaiser’s an exception."

Meanwhile, the HMO is proposing a 5.3 percent rate hike on Jan. 1 for more than 150,000 members covered by employer-sponsored health plans. At the same time, the company is seeking to raise premiums 9.1 percent for more than 14,000 individuals, according to the state Insurance Division, which regulates health plan rates. Kaiser recently announced that it will boost premiums next year for supplemental Medicare coverage as well.

The organization also is being sued by the Queen’s Medical Center for more than $4 million and other unspecified punitive damages for allegedly underpaying the hospital for caring for its members after a contract expired that allowed discounted payments.

"Kaiser, like most health care systems, is in transition. I think we’ll see expansions and contractions in the workforce," said Deborah Gardner, executive director of the Hawaii State Center for Nursing. "I don’t think we should be surprised to see a change in how health care is delivered. With health care reform, everybody’s really trying to figure out how they’re going to do more with less and still provide good patient care."