It is expected that at least 40 percent of the U.S. population over 75 will need extensive health care services late in their lives. The profession of Speech Pathology must be ready and be prepared. This session will reflect on the national goals for healthcare reform and the evolving changes those reforms will bring to rehabilitation and specifically the clinical speech-language pathologists (SLPs) since the codification of the Affordable Care Act. The three-part aim is a core principal of the ACA that improves health care quality, reduce costs and increase patient satisfaction and access. Careful overview presentations of Centers for Medicare & Medicaid Services (CMS) role in projects such as the (HICA) innovations grants, CARE demonstration projects, Accountable Care organizations, Federally Qualified Health Centers (FQHCs), Telemedicine and the COP payment rules will be discussed as will health disparities and health literacy. The session will offer a modified historical review of CMS and shed light on the $100 million dollars for the health care innovation challenge grants (HCIA). Lastly, the American Speech-Language-Hearing Association's (ASHA) role in preparing SLPs for the future in healthcare, will be highlighted.