There is little doubt that the healthcare industry is experiencing revolutionary change. The effects on care delivery organizations are profound. One analyst predicts that a third of hospitals will close by 2020. A recent survey revealed that nearly 60% of physicians say the practice of medicine is in jeopardy and that six in ten plan on early retirement in the next few years. Increased shifts in payment from commercial insurers to Medicare/Medicaid combined with the aging boomer population promises to put additional pressure on margins. Increased revenue from the Affordable Care Act (ACA) is expected to be offset by increased administrative costs due to its implementation and the added compliance requirements from ICD-10.