Quality has been a key concern in the provision of care for a number of years, in both the hospital and long-term care settings. The ACA, while touching on many other concern, is the first policy that fully incorporate quality of care and performance into the reimbursement component. Prior to the ACA, the provisions of care was all that was necessary for payment. Withholdings and incentive payments exist that will depend on improvement from health care providers in order to receive them. Value-based purchasing and ACOs require minimum scores from CMS for participation in programs, thus without the ability to participate, revenue will be deeply impacted. It is, therefore, imperative for providers to assess themselves and create action plans
