Perhaps the most uncertainty in the industry stemmed from the rollout of the Patient Protection and Affordable Care Act’s healthcare exchanges. For months leading up to their launch, health systems worried as they struggled to estimate, and therefore plan for, the number of patients who would enroll in plans offered on the exchanges and reimbursement rates under these plans.

When the exchanges did launch, they launched in the midst of a federal government shutdown. And, the federal exchange website, www.Healthcare.gov, experienced weeks of technical difficulties, forcing the Obama administration to delay the start date for imposing penalties on the uninsured by six weeks, at the time this issue went to press. What other issues impacted hospitals and health systems the most during 2013? Following are 10 of the biggest stories covered in the pages of Becker’s Hospital Review throughout the year.