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Hospitals cite worry on fees in health bill

New York Times, November 3, 2009

A provision in the House healthcare bill, included over the objections of urban hospitals, would order a neutral group, the Institute of Medicine, to conduct a two-year study of regional variations in Medicare spending. The bill requires the institute to recommend changes that would reward "quality and value," and those changes would take effect automatically unless Congress objected by May 31, 2012. Proponents say the institute's findings could prove crucial to efforts to slow out-of-control costs. But opponents argue that some of the most efficient hospitals are in affluent and rural areas that do not face the same challenges, including higher poverty and cost of living, as urban areas.