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Integral to the search for accountability in the U.S. healthcare system are new reimbursement and benefit models that provide incentives to achieve measurable positive health outcomes. Not all of these efforts are built around capitated reimbursement, but many contain elements of risk. Given the initiative by Blue Cross and Blue Shield of Massachusetts to pay doctors and hospitals in its network a fixed PMPM amount with a bonus for improving care, an approach undertaken in neighboring Maine is worth a look.