Patient Protection and Affordable Care Act: potential effects on physical medicine and rehabilitation

The objective was to review pertinent areas of the Patient Protection and Affordable Care Act (PPACA) to determine the PPACA's impact on physical medicine and rehabilitation (PM&R). The law, and related newspaper and magazine articles, was reviewed. The ways in which provisions in the PPACA are being implemented by the Centers for Medicare and Medicaid Services and other government organizations were investigated. Additionally, recent court rulings on the PPACA were analyzed to assess the law's chances of successful implementation. The PPACA contains a variety of reforms that, if implemented, will significantly impact the field of PM&R. Many PPACA reforms change how rehabilitative care is delivered by integrating different levels of care and creating uniform quality metrics to assess quality and efficiency. These quality metrics will ultimately be tied to new, performance-based payment systems. While the law contains ambitious initiatives that may, if unsuccessful or incorrectly implemented, negatively impact PM&R, it also has the potential to greatly improve the quality and efficiency of rehabilitative care. A proactive approach to the changes the PPACA will bring about is essential for the health of the field.