When the talk is about paying for quality instead of quantity they are referring to outcomes. Do Dr. Y's patients with Type 2 Diabetis maintain HgbA1C levels of 6.5 or below? Do Dr. Y's Type 2 Diabetics get a HGBA1C ordered every 3 months? The various forms of how outcomes will be used for payment reform is yet to be decided. It is currently in an embryonic stage in the Medicare program called PQRI and was not very sucessfull for clinics.

One of the things being wrestled with is how to look at outcomes when the patient does not follow recommended treatment.

Because of the high costs of running a private clinic and the ever dwindling reimbursement for services most Primary Care Physicians have already joined some type of employer.

The more concerning issue is that there are fewer and fewer med students who select this field.