Pay for Performance, Version 2.0?

“Old wine in a new bottle.” “A financial gamble.” “An early glimpse of the next generation of pay for performance.” All these appraisals have been applied to Geisinger Health System's new approach to elective coronary-artery bypass grafting (CABG), which has been described with words rarely invoked in health care, such as “promise” and “guarantee.” Geisinger, an integrated health care delivery system in northeastern Pennsylvania, promises that 40 key processes will be completed for every patient who undergoes elective CABG — even though several of the “benchmarks” are to be reached before or after hospitalization. And although Geisinger cannot guarantee good . . .