It's the new managed care motto: cheaper care is better care. But a trio of studies by researchers at Intermountain Healthcare—often cited as a model of efficiency and cost control—shows it's more complicated than that. "Everyone is running around and saying value equals quality divided by cost," said John C. Ruckdeschel, medical director of Intermountain's Oncology clinical program. "But if you accept cost as the denominator, you would always assume doing the cheaper thing is better, and that's not always true. It sounds simple, but it's really very difficult," said Ruckdeschel, who shared results from the experiment this winter at the American Society of Clinical Oncology's first Quality Care Symposium.