The healthcare law makes a big bet: Tethering providers' salaries to the quality of care they provide will improve outcomes. A team of researchers at the British Medical Journal, however, sound a note of caution. Where some see potential for cost savings, they see a system that doctors could easily game. Steffie Woodhandler, Daniel Ariely and David Himmelstein have an editorial (that goes with an accompanying article) outlining all the reasons that pay-for-performance may not work in healthcare. Chief among them is the problem of "up-coding."