In pursuit of greater efficiency in the United States health system, public programs and private insurers have begun to pay some hospitals and physicians differently. These new payment models take many forms, but they all impose greater responsibility for cost control and quality improvement on providers and bear some resemblance to failed health care financing arrangements from the 1990s. However, there are some distinctions that could make all the difference. A recently announced partnership that includes Anthem Blue Cross in California and seven Los Angeles-area hospital systems exemplifies these new models.