With 196 employees accepting the early retirement offer, officials at the Crozer-Keystone Health System whittled the number of employees targeted for layoff from 325 to 30. Of the 30 positions, 22 are management. The last time layoffs were made in the system was three years ago. Earlier this month, Crozer-Keystone administrators held employee meetings to encourage early retirements to reduce the number of potential layoffs in the 7,000-employee work force. Officials blamed the cuts on the health system receiving fewer reimbursements from insurance companies because of the shift from inpatient to outpatient care. Over the last 18 months, Crozer-Keystone had 25 percent of its inpatient care switch to outpatient.