Inpatient admissions at many hospital systems kept falling during  2014’s third quarter.  Changes tied to healthcare reform were cited, including Medicare’s “two-midnight rule,” which has shifted many patients to ”observations” from admissions. But of course, Medicare is doing other things with financial incentives to control costs by shifting patients away from hospitals.

Further explaining the decline is the increase in high-deductible health plans with hefty co-payments and co-insurance.