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With three offices and a surgery center covering a 40-mile radius in California's San Gabriel Valley, California Eye Specialists is one of the largest ophthalmic delivery organizations in greater Los Angeles. With more than two decades of experience in capitation and a current patient population numbering 160,000 covered lives, the medical group also is a force in risk contracting. Despite the organization's significant managed care expertise, its attempt to upgrade its IT platform was nearly disastrous. The group's experience serves as a cautionary tale for single- and multispecialty medical groups that are motivated by capitation to focus on efficiency in their medical practice.