Hospital operators feeling the pinch from reduced inpatient volumes due to the Centers for Medicare & Medicaid Services’ new regulations to better define when a short-term stay should count as an inpatient stay are certainly not alone. According to financial analysts at the prestigious Moody's Investors Service,  the new inpatient billing rule referred to as the “two-midnight rule” will put financial pressure on hospitals for some time to come.

In a continuing Health Affairs series, Catalyst for Payment Reform Executive Director Suzanne Delbanco digs into the evidence for Pay-for-Performance (often called P4P) as a payment system that may potentially reduce overall health care costs.According to Delbanco, pay-for-performance may indeed be useful in shifting providers toward new payment systems because it only has an upside. You get a bonus if you improve certain quality measures and you earn the same if you don't.However, she warns that the lack of financial risk in P4P may limit its usefulness. Research also has not shown that it can lower costs, a key purpose of new payment systems. Finally, it may encourage physicians to focus on a narrow band of measurable quality measures to the detriment of the overall quality of the care the patient receives.Delbanco theorizes that the true value of P4P may be as a stepping stone to shared-risk arrangements with payors.

The many regulatory, reimbursement and policy changes related to the Patient Protection and Affordable Care Act are undoubtedly changing the business climate for physicians. In a feature with video, the New York Times contrasts the practices of two Kentucky primary care doctors — Sven Jonsson, M.D., and Tracy Ragland, M.D. — to illustrate the economic pressure pushing many sole practitioners into employment by large health care networks.

Timothy Gilligan, M.D., co-director of the Center for Excellence in Healthcare Communication at the Cleveland Clinic, and Mikkael Sekeres, M.D., director of the leukemia program at the Cleveland Clinic, provide a well timed caution on the physician communication training trend.

Dislike the Open Payments regulations (also known as the Physician Payments Sunshine Act) that are part of the Affordable Care Act? In a blog post for Health Affairs, Anita Griner, deputy director of the Data Sharing and Partnership Group at the Centers for Medicare and Medicaid Services' Center for Program Integrity, explains why the regulations are a good idea and the burden they may create on physicians and manufacturers is likely overstated.

Shopping for health care based on price is still fairly rare and exceedingly difficult to do. However, the Wall Street Journal reports that the push toward price transparency is growing despite the barriers.

Reston, VA, February 10, 2014 -- The Workgroup for Electronic Data Interchange (WEDI) in partnership with the Centers for Medicare and Medicaid Services (CMS), the Cooperative Exchange and other private industry partners, today announced the launch of its ICD-10 Success Initiative webinar series. The purpose of these webinars is to help health IT stakeholders meet the October 1 ICD-10 compliance deadline and to provide answers to common questions.

The government's release of first-year cost-savings results for its accountable care organization (ACO) project and the Centers for Medicare and Medicaid Services (CMS) Innovation Center delivery system reform pilot projects have drawn criticism from both the New York Times and the Washington Post, which published articles pointing out the problems with drawing conclusions from studies that are not true randomized controlled trials. In short, correlation is not causation, and the early results, while interesting, are not the same as proof that ACOs and new reimbursement methods like bundled payments actually deliver better care more cheaply. In a commentary, Bloomberg News summarized the controversy.