Healthcare organizations around the world are faced with the challenges of containing rising healthcare costs, improving access to care, and providing quality care to patients with very complex diseases and longer life spans (due to vast improvements in medical research and technology).  The impetus to provide quality care has resulted in a demand for healthcare providers to increase RVUs, decrease emergency room visits for non-emergent care and increase patient satisfaction within the primary care setting.  As a result, healthcare organizations and the federal government have turned to pay-for-performance incentives to reward providers for increasing efficiencies, improving access to care. And improving healthcare outcomes for patients with diabetes, hypertension and other life-threatening but manageable diseases. While pay-for-performance programs are great Human Resource recruitment strategies, can they really improve clinical outcomes, quality of care, contain costs, and improve patient satisfaction?  Absolutely.   Coupled with wellness, behavior modification and preventive healthcare programs and consistent, accurate, quantitative data analysis; pay-for-performance programs can achieve the desired results for both patients and healthcare organizations alike.  The challenges that exist for healthcare providers are churning and burning to meet demand management.  With the focus on increasing RVUs and revenue, providers are treating more patients per day, which leaves little time for providing wellness education or referring patients to preventive healthcare programs.  Providers end up treating their patients’ current symptoms, providing medication and advising them to schedule follow up appointments.  Consequently, obese patients are less likely to self-refer to weight management classes or take necessary steps to lose 10-15 pounds which studies have shown decrease pressure on the heart and significantly lowers high blood pressure.  This type of patient/provider relationship also lowers the chances of diabetic patients getting bi-yearly tests for glaucoma, AC1 testing, and leaning about the benefits of healthy eating to decrease the devastating effects of the disease.   This often results in obese and diabetic patients requiring extensive inpatient care and numerous costly but possibly avoidable surgeries.  If healthcare organizations do not change this behavioral pattern for providers and patients, pay-for-performance programs will continue to stagger or fail altogether