One that is proliferating now is vertical integration, where a hospital primarily integrate freestanding physicians, urgent care centers, rehabilitation centers, nursing homes, sometimes insurance companies into everything for everybody source of care. So this payment system is very awkward, and it typically pays more for the same care that is provided in a hospital than care that is provided in other settings, like an urgent care center, or a retail medical system. REGINA HERZLINGER: Well, the Affordable Care Act had two main cost levers, both of which were levers that called for the integration of care.