Pay-for-performance incentives show benefits in Maryland. Despite criticisms of incentive programs (see "Regulatory Issues, Incentives, and Nurses," In the News, January), not all of the news is bad. Between 2007 and 2010, a quality-based reimbursement program and a pay-for-performance program in Maryland hospitals led to better care and cost savings. The use of process-of-care measures, such as giving aspirin to heart attack patients when they reach the hospital, increased by 7.31%, compared with an increase of 6.86% nationally. Hospital-acquired conditions, including urinary tract infections and septicemia, fell by 15.26%, leading to a savings of $110.9 million, or 0.6% of total inpatient costs. If scaled up nationally, the Medicare fee-for-service program could save $1.3 billion over two years. The results suggest that "consistent and powerful financial incentives can motivate considerable and focused efforts to improve hospital outcomes," write the authors in the December 2012 Health Affairs.