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It’s not just the FDA that is making life difficult for medical device companies. Executives are having to follow sales opportunities as medical care shifts out of hospitals into homes and physician offices. They are having to revamp their entire business model to survive in the new world of the ACA.

A.T. Kearney has identified the five forces that are forcing the device industry to evolve in this new report: Medical Devices: Equipped for the Future? In addition to spelling out the threats, the analysts have a guide for how to start building a new business model.