Interrelation of Organization and Payment Integrated system capitation Global DRG fee: hospital, post- acute, and physician inpatient Global DRG fee: hospital only Global ambulatory care fees Global primary care fees Blended FFS and medical home fees FFS and DRGs Outcome measures; large % of total payment Less Feasible Care coordination and intermediate outcome measures; moderate % of total payment Continuum of Payment Bundling Continuum of P4P Design More Feasible Preventive care; management of chronic conditions measures; small % of total payment Small MD practice; unrelated hospitals Primary care MD group practice Multi-specialty MD group practice Hospital system Integrated delivery system Source: A. Shih, K. Davis, S. Schoenbaum, A. Gauthier, R. Nuzum, and D. McCarthy, Organizing the U.S. Health Care Delivery System for High Performance (New York: The Commonwealth Fund, Aug. 2008).