Are hospitals responding to a health reform that hasn't happened yet?

The money America spends on health care has been growing at a historically slow pace over the past five years. Some of the slowdown is surely due to the economy—after people lost jobs and their health insurance, they went to the doctor less. But it turns out that Medicare spending per enrollee, adjusted for inflation, has also dropped over the past three years—a sign that the deceleration in health spending is happening independently of the ups and downs of the economy and that policy changes might be at work.