Its flagship academic medical centers in Boston, Massachusetts General Hospital and Brigham and Women’s Hospital, anchor a health care hub that is arguably the best in the country, if not the world. Reimbursement rates from insurers are growing more slowly than expenses.

BOSTON - Mass General Brigham, the largest health care system in Massachusetts, announced layoffs Monday that will affect hundreds of workers, citing a $250 million projected budget gap.

At least three high-level employees at Nantucket Cottage Hospital left abruptly recently, after the parent company of the island's only hospital announced layoffs last week.

Mass General Brigham attributed the layoffs to an expected budget shortfall of $250 billion over the next two years.

Mass General Brigham announced mass layoffs aimed to bridge a $250 million budget gap projected over the next two years in a letter to employees Monday — meaning potentially hundreds of