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Volume 359:1197-1200 September 18, 2008 Number 12 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Escalating costs and the growing imbalance between primary and specialty care have increased the urgency of calls for fundamental reform of the health care payment system. At the core of the problem is the fact that the dominant fee-for-service model rewards volume and intensity rather than value. But although the faults in the way we currently pay for health care are obvious, it is much less clear what feasible approach would yield better results.

Earlier this decade, pay for performance took center stage as a tactic for realigning payment with value. Payers' experiences during this period, as well as several . . . [Full Text of this Article]

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Dr. Rosenthal is an associate professor of health economics and policy at the Harvard School of Public Health, Boston.

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