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Small rural hospitals called critical-access hospitals have in recent years been performing more and more inpatient orthopedic surgeries, even as their overall stays decline, a Journal analysis of Medicare billing records shows. Inpatient joint-replacement surgeries covered by Medicare rose 42.6% at the hospitals from 2008 to 2013, far outpacing the growth of those services at general hospitals. The trend reflects financial incentives built into the way Medicare pays the nation’s roughly 1,300 critical-access hospitals—generally isolated facilities with 25 or fewer beds—experts say, but it has troubling implications for patient safety. Many studies suggest that patients generally get better results when their procedures are done at hospitals that perform them frequently. (Weaver, Mathews and McGinty, 12/25)

Due to an obscure bit of regulatory wording, Medicare patients pay far more out of pocket for outpatient care at the small, rural hospitals known as critical-access hospitals than they would for the same care elsewhere, according a Wall Street Journal analysis of Medicare billing records. (Beck and Weaver, 12/25)

Imagine you're diagnosed with cancer. Your doctor says your survival chances are good but that, even in the best case, it will take months to get better. Checking your health care coverage, you find you'll be paying thousands of dollars in costs before your high-deductible insurance plan kicks in. You may have other expenses too — maybe you'll need help talking care of your kids, or your house. It's a nightmare scenario that worries many, for good reason. (Zdechlik, 1/4)

Health insurers in several big cities will take some pain out of doctor visits this year -- the financial kind. They’ll offer free visits to primary care doctors in their networks. You read that right. Doctor visits without copays. Or coinsurance. And no expensive deductible to pay off first. Free. (Galewitz, 1/4)

Are hospitals doing everything they should to make sure they don't make mistakes when declaring patients brain-dead? A provocative study finds that hospital policies for determining brain death are surprisingly inconsistent and that many have failed to fully implement guidelines designed to minimize errors. (Stein, 12/28)