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Medicare has tied incentive payments and penalties to two-dozen quality measurements, including surveys of patient satisfaction and death rates. More than 1,200 hospitals are receiving bonuses. But more hospitals are being paid less for each Medicare patient they treat for the year that began Oct. 1.

Plans offering coverage that lasts 364 days can cost half as much as those that are in force for a year. But the savings may be illusory for people who need care for injuries or illnesses because the coverage can be skimpier.

Maryland-based Evergreen Health Co-op is one of nearly two dozen nonprofit insurers created by the health act. They will be owned by the policyholders and are supposed to add competition and lower prices for coverage. they're supposed to add competition and lower prices for medical coverage. But they can't do either without customers.

Over the next few months people across the U.S. will have to make decisions about health coverage. The questions about how that it will all work keep coming in, with people seeking details about available plans and the size of the penalties if they don't comply.

The Affordable Care Act included a sales tax on medical devices that is supposed to help pay for the expansion of health insurance coverage. But the tax is being levied on some devices, such as ultrasound scanners, that are used to diagnose and treat animals instead of humans.

President Obama says he's pretty frustrated with the messed-up computer system for insurance enrollment under the Affordable Care Act. If he gets it fixed by mid-November all will be well, analysts say. But further delay could mean real trouble.

Despite the federal overhaul of health care, people in the pools are left out because of a wrinkle in legal language. The high-risk pools aren't licensed as insurers in most states, so they're not subject to the federal law.

Bipartisan bills are pending again in both the House and Senate to give buyers of hearing aids a small tax break. But, once again, it looks as though the legislation has a long way to go before it could become law.

As biotech investments and medical device development falters, hospitals are turning to other avenues to help cut costs: streamlining billing systems and investing in simpler medical products.

Before a colonoscopy, ask the doctor about his or her detection rate for polyps. And find out how long, on average, the doctor takes to withdraw the scope from the patient. About 10 minutes is the optimal duration, a recent analysis says.