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Tanenbaum SJ – The article analyzes the political reasons for Medicare P4P's popularity despite its evidentiary deficiencies and emphasizes its role in the politics of value. Pay for performance allows Medicare policy makers to reformulate intractable cost and quality problems as more malleable value problems; offer an acceptable quid pro quo for payment negotiations with providers; and reach a rare, if shallow, consensus based on the ideological ambiguity of P4P.

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