Premise:
"Those others are presumably still in office."
Hypothesis: There are 20 still in office.

it is not possible to tell

Premise:
"describing percent changes in payments per case due to changes in the prospective payment system for operating costs."
Hypothesis: Nothing is being described especially not percent changes.

no

Premise:
"and you make sure that you keep up with them for the next time we got one of those kind that have got the"
Hypothesis: We have got to keep up, or beat them.
it is not possible to tell