Since the Affordable Care Act was signed into law, it's affected individuals, families, businesses, and one of the most obvious, the health care industry.

Valley Health says as a not-for-profit health care system, they're not sure about the full impact just yet.

There are various elements of the act that Valley Health president and CEO, Mark Merrill says will be positive, such as expanding coverage and health insurance exchanges. Yet, he says there are also some challenges.

"Some of the penalties are the right things but we do have issues dealing with coordination of care. And so hospitals are being asked to coordinate care without any reimbursement for that, so we're making investments in that. But in terms of the overall arching objectives, it should have a positive effect," said Merrill.

Merrill says in the past, hospitals have been paid for volume. So, the more services given, the more money they make. Now, because of the Affordable Care Act, he says they'll also be rewarded for their outcomes. That's part of the 'pay for performance' program.

Hospitals that do well will get an incentive and the ones who do poorly will get a penalty. He says it'll be more competitive for hospitals to improve their performance levels.

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