In taking an in-depth look on the market power of Medicaid, you can clearly see they make up more than half of the payer market. With Medicare being one of the primary payers in the healthcare industry it drastically affects providers in either positively or negatively based on the changes. Pre Affordable care act post-acute care services, skilled nursing services, inpatient rehabilitation services, long-term care services, home care services, and hospice services were growing at an astonishing rate. Year over year Medicare spending rose on average 6-8 percent and seemed to be the future of Medicare expenditures. In 2012, fee-for-service Medicare spending on skilled nursing, rehabilitation facilities, long-term care hospitals and home
