URBANA – Illinois hospitals stand to lose $4.5 billion in Medicare reimbursements over the next five years under President Bush's proposed budget.

And the impact, according to the hospitals, would be devastating.

"They're already losing money on every Medicare patient they get," said Ken Robbins, president of the Illinois Hospital Association.

The Bush administration, seeking to slow the growth of Medicare, called for $182 billion in Medicare cuts over the next five budget years starting Sept. 1, and hospitals would bear the brunt of the reduction, according to the state hospital association.

Robbins said hospitals would see Medicare reductions in three major areas: inpatient care, outpatient care and medical education.

That includes reductions in special medical-education payments made to teaching hospitals such as Carle Foundation Hospital in Urbana, which serves as an instructional site for medical students at the University of Illinois.

Carle has projected it would lose $45 million overall because of the Medicare cuts over the five years, its chief financial officer, Robert Tonkinson, said.

Mokena-based Provena Health estimates it would lose $135 million over five years for all six of its hospitals, including Provena Covenant Medical Center in Urbana and Provena United Samaritans Medical Center in Danville.

Sarah Bush Lincoln Health Center in Coles County would take an approximately $15 million hit in Medicare reimbursements over the five years, a figure that would have a "significant impact" on its bottom line, said hospital Chief Financial Officer Craig Sheagren.

The Illinois Hospital Association says the state's hospitals derive nearly 41 percent of their total gross revenues from Medicare reimbursements, and those payments cover about 90 percent of the cost of caring for Medicare patients.

And the losses can only grow as baby boomers become older and sicker.

Robbins said hospitals in Illinois are also under increasing pressure to increase the amount of charity care they provide to needy patients, and providing that help becomes more difficult when other sources of payment are reduced.

"They don't have printing presses for money in their basements," he said.

Hospitals are gearing up for a fight, Robbins said, but politics are probably on the hospitals' side.

"We take this very seriously, and we will be fighting these cuts in Congress, but the likelihood of a budget that makes these kinds of cuts passing through a Democratically controlled Congress in the last year of a Republican president's administration are slight," he said.

Still, he urges, hospitals and patients shouldn't relax about Medicare funding.

"The hospital community and the patients they serve are going to have to make sure their legislators would know the impact of these cuts."