As part of the Affordable Care Act, the federal government adjusts reimbursements to health-care providers up or down based on the quality and cost-effectiveness of their services, as measured by a set of standards established by the Centers for Medicare and Medicaid Services (CMS). The standards use metrics such as how long emergency-room patients must wait to be seen and how long it takes heart-attack victims to get stents placed in their blocked arteries. The intention is to encourage savings and sound practices and enhance patient satisfaction.

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