Faced with a rising number of uninsured patients and unknown impact of the new healthcare law, Piedmont Healthcare announced Thursday evening plans to cut 464 jobs as part of an effort to save an estimated $68 million. Totaling roughly 5 percent of its workforce, the cuts include 171 positions that were vacant or altered because of scheduling changes. Layoffs are coming from across the board, including Piedmont's four hospitals, physicians group, heart institute and corporate division, spokeswoman Nina Day said. "This is heart-wrenching," Day said. "This is not easy stuff when you're talking about people." The move is, in part, a reaction to hurdles many hospitals are facing, including a growing number of uninsured patients, a new state hospital bed tax, anticipated cuts to Medicare reimbursements and the Medicaid expansion in 2014, Day said.