Federal payment reductions to hospitals will reach $218.2 billion by 2028, according to a report released today by the health care economics firm Dobson DaVanzo and Associates. Commissioned by the AHA and Federation of American Hospitals, the study looked at how 11 pieces of legislation combined with numerous regulatory changes would affect hospital funding from 2010 through 2028. "Continued cuts of this magnitude represent a troubling trend for hospitals and health systems as many struggle with declining reimbursements for services provided in and out of the hospital," said AHA President and CEO Rick Pollack. "As noted in other recent reports, Medicare margins have hit a 10-year low and almost a third of hospitals now have negative aggregate margins across all payer types. Additional reductions will create challenging and potentially unsustainable financial circumstances that could adversely impact patients' access to care and the ability of hospitals to provide services."