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Rural health care administrators got some good news this week.

The Obama administration Monday proposed to ease some Medicare – a change that could save rural hospitals much-needed money by allowing for more flexible staffing requirements. But for about 450 health care professionals who attended this week’s in Washington, D.C., sustaining the often low-volume hospitals will continue to be an uphill battle.

“We are going to lose hospitals,” said Lance Keilers, administrator at Ballinger Memorial Hospital in Texas, at a panel on Monday titled Threats to Rural Hospitals.

Keilers said the possibility of the reduced government payments resulting from the scheduled budget cuts, or sequestration, is not the only test these facilities face. He pointed out other possible threats from government regulation – like if another nearby hospital opens. If this happens, health advocates said some rural communities will have less access to medical care, and states like  North Carolina would see thousands of job cuts in the industry.

Meanwhile, rural hospitals are often more efficient and cheaper to run than their urban counterparts serving a similar patient mix, according to Gregory Wolf, vice president of .

Some attendees expressed the imperative to make sure members of Congress understand the difficulties rural hospitals face in this current fiscal climate.

“There’s a sense on Capitol Hill that rural hospitals are doing fine,” said Eric Zimmerman, a D.C.-based attorney who represents health care systems in matters of Medicare. He said the reality of shrinking budgets and the stress of transitioning to different payment methods was often lost in the policy-making process.

Keilers said the only way forward to prioritize rural-friendly legislation on the Hill was through cooperation and collaboration.

“This is it guys, we’re rural, we better stick together.”