The Balanced Budget Act of 1997 (BBA 97) contains the most dramatic changes to the Medicare program since its genesis nearly 35 years ago. To remain financially viable under the cost-cutting measures mandated in this Act, hospitals, home health agencies, skilled nursing facilities, and their employees must have a working knowledge of its contents. In addition, the patients served by these health care providers must have well documented and positive health outcomes, and they must be satisfied with the care and service they receive. Nevertheless, merely understanding the changes mandated by BBA 97 is not sufficient for success; clinicians also must develop innovative solutions to the hurdles the Act erects and quickly integrate them into daily practice. Issues of payment and reimbursement have everything to do with the delivery of today's patient care, regardless of the setting where it is delivered. BBA 97 offers special opportunities to wound, ostomy, and continence care clinicians.