A study in the NEJM found that when nearly 1700 patients were discharged for heart failure and had intensive telemonitoring (patients were to call in daily, using a touch-tone pad to deliver information on weight and symptoms), there was no benefit in mortality or hospital-readmission rates. Can you believe this? I can. This is the beauty with insurance companies, hospital administrators, committees and even the government coming up with new bureaucratic rules or hurdles without proving them. This seemed like a great idea but, guess what, it failed. I love the end of this article where they point out a a need for caution before inserting additional loops into disease management." Additional loops? It's all loops! Pay-for-performance has never been proven to work. And now our whole healthcare system is going to be based on it.