Many Medicare beneficiaries treated at primarily rural "critical access" hospitals end up paying between two and six times more for outpatient services than do patients at other hospitals, according to a report released Wednesday by the inspector general at the Department of Health and Human Services. There are more than 1,200 critical access hospitals, which are generally the sole hospital in rural areas and can have no more than 25 beds. Medicare pays them more generously so they won't go out of business. In Illinois, 50 hospitals, more than a quarter, hold this designation.