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As pay for performance (P4P) moves from an idea to a reality, you must prepare to deal with the requisite day-to-day questions: How can you align P4P with the culture at your organization? How will physicians respond to P4P incentives? What is the best way to distribute P4P revenue? For P4P to be effective, providers need to align reimbursement mechanisms with their current internal compensation plans. This ensures that the quality measures that generate additional revenue for the facility as a whole will closely align with the criteria that determine revenue division among physicians.