Over the past year, doctors who run Mayo Clinic pressed for changes that would see Medicare reward the most efficient hospitals and pay less to the least efficient in an effort to cut waste, raise quality, and save money. Now, if a health bill passes it's likely to include a payment formula that would reward efficient, high-quality providers like Mayo. But with some $250 billion in annual Medicare hospital spending at stake, the new payment formula has created a huge fight between potential winners and losers, the Minneapolis Star Tribune reports.