ABSTRACT

Healthcare is probably one of the most complex business models in American industry given the uniqueness of the marketplace in which it operates. It is perhaps the only industry in which the consumer does not necessarily pay for the service he or she receives, but rather third parties negotiate arrangements with service providers to determine payment rates and types of service that are to be paid on the consumer's behalf. The Affordable Care Act has transformed the face of healthcare delivery in profound ways on many levels. It is rapidly changing the very manner through which providers are reimbursed by emphasizing "value-based reimbursement," which in government-speak means that providers will be directly rewarded financially for demonstrating excellent care and may be penalized financially for care that does not meet the quality standards laid out by the Centersfor Medicare and Medicaid Services.