The “secret Key” is to align the financial incentives of the physicians (who drive over 80% of patient care & testing costs) with insurers (who process bills – they more bills they process, the more they profit) with hospitals (who have huge fixed costs, so like a hotel, an empty bed make $0 contribution to overhead costs), with manufacturers (who make increased profit with single use “disposables”).

Fully fucnctional EHR/EMR will be a powerful tool to also align cost and outcome data to shift the model to reimburse for efficient, quality healthcare.

The rapidly developing Hospitalist model of care will also be very powerful once they begin to implement P4P.