Since the Affordable Care Act became law five years ago, it has led to major shifts in health care delivery and payment. A new report from the PwC Health Research Institute identifies five trends sparked by the ACA that drove these changes: risk shifts from traditional insurers to providers, pharmaceutical companies and patients; financial boost for primary care from commercial and public insurers; new entrants to the industry take on everything from data analytics to mobile technologies; enrollment in public exchanges shows potential of retail-style health insurance; states emerge as key players because of latitude in implementing the law. www.pwc.com/hri