Within just a few weeks of each other, the House of Representatives voted to repeal the Patient Protection and Affordable Care Act and the CMS finally published its proposed Value-Based Purchasing rules.  These events illustrate the irony of the situation.  While Congress fights over ‘Healthcare Reform’ – real reform continues, unaffected by the political struggle.  Reform has been underway for several years and will continue because the current situation is simply not economically viable.  What we know: