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Proponents of pay-for-performance (P4P) programs say the benefits include cost reductions, fewer errors, and improvement in overall quality of care. These potential outcomes have led several government agencies-including CMS-to develop their own pay-for-performance initiatives. The benefits and penalties are major incentives for hospitals and physicians to improve care in these categories, says Susan L. Freeman, chief medical officer at Temple University Hospital in Philadelphia and a consultant for The Greeley Company, a division of HCPro, Inc., in Marblehead, MA. But the P4P forecast isn't all rosy.