CHICAGO — Smaller urban hospitals are especially vulnerable to fallout from cost-cutting measures that are certain to be part of a final health care reform bill now being debated by Congress, said Moody’s Investors Service.

Stand-alone hospitals located in expensive, urban areas are typically more dependent on high-cost Medicare reimbursements than other providers. It is those hospitals that likely will suffer the most from cuts — and possibly from downgrades — under federal reform that features Medicare cuts, Moody’s said.

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