The Cleveland Clinic is cutting costs and trimming its $6 billion annual budget as patients and providers grapple with health care changes in the U.S.

The clinic plans to shave 5.5 percent from its yearly spending by tightening operations budgets for things like travel, filling vacancies only where necessary and combining services in areas where there are overlapping offerings, said spokeswoman Eileen Sheil. The clinic will offer early retirement to 3,000 employees and may cut jobs if it can’t otherwise reach $330 million in savings for 2014, she said.

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