Memorial Health Care System announced layoffs of about 70 people Thursday, the third area hospital to cut staff this year. In a news release, Memorial President and CEO James Hobson cited the economic recession and hospital reform as reasons for the cuts. Changes in the hospital industry mean shifts to outpatient settings and other ways to deliver health care, he said, and more people also are delaying medical care or forgoing elective procedures. On Thursday, Memorial Hospital spokeswoman Lisa McCluskey said the employee layoffs are not directly related to stalled negotiations over payment rates from BlueCross BlueShield of Tennessee. But she said low reimbursements from the insurer make it difficult to handle rising expenses at the hospital.