Changes to federal Medicare funding has rural, critical access hospital officials worried about the future.
There's 15 of them in Oregon, two in Central Oregon -- Prineville's Pioneer Memorial and St. Charles-Madras are at risk.
"The impact of this could be really huge. In Oregon that means 60 percent. 60 percent of critical access hospitals will close," Robin Henderson, director of government strategies at St. Charles Health System, said Thursday.
"Critical access" facilities are more than 35 miles away from the nearest hospital. They receive higher Medicare payments under a program dating from the late '90s. But a proposal in Washington, D.C., cuts that funding -- potentially saving the government millions.
But it also could cut off medical service access to thousands.
"You would also be putting Warm Springs at an extreme disadvantage," Henderson said. "They would now be more than 50 miles way from their closest health care system. That's a long haul."
It's still early, however, and officials aren't sure if the hospitals would close or just have their services cut back dramatically.
More than 200 jobs are at stake at each hospital, and it's difficult to keep a hospital staffed with little to no federal financial help.
"These are third- and fourth-largest employers in their communities, and taking jobs away from the most economically disadvantaged places in our country just doesn't make any sense," Henderson said.
Henderson said shifting patients to urban hospitals could end up costing Medicare more. The cost per Medicare patient is 3.7 percent lower in rural areas than in urban ones.
"How we care for people who have chronic health conditions -- that's local," Henderson said. "People aren't going to drive to Bend to treat something that's chronic and ongoing, like asthma."
Bob Gomes, CEO of St. Charles Redmond/Prineville, said, "It's about access, and when you have someone that's sick and in the hospital, and to be able to get that care 20 to 30 miles away -- it's tough on them. But it's also tough on the family and support system they have in place."
Officials agree the new program would not only affect the hospitals but the people who use them.
"It's more than just about this building -- it's about this community," Henderson said.
The proposal hasn't made its way into any legislation yet, but Henderson said she's already sent letters to Rep. Greg Walden, R-Ore., and Sen. Jeff Merkley, D-Ore., as well as Bend state Rep. Jason Conger and Sen. Tim Knopp, hoping they can help if the move advances.