Explore the complex issue of rising healthcare costs in this 52-minute Grand Rounds presentation by Dr. Michael Kitchell, a neurologist from McFarland Clinic. Delve into topics such as the delivery of healthcare, medical homes, quality ratings, value-based purchasing, and physician pay. Examine the concept of Accountable Care Organizations (ACOs) and how they differ from Health Maintenance Organizations (HMOs). Learn about quality and cost measures, including the Physician Quality Reporting System (PQRS) and group report cards. Discover strategies for reducing administrative costs and improving healthcare quality. Discuss the challenges of fee-for-service models, embedded quality measures, and Medicare payment decisions. Gain insights into how healthcare providers are rewarded, the impact of inflation and aging populations, and the complexities of medical decision-making in areas such as IV antibiotic use.