For example, the Comprehensive Primary Care Initiative (http://1.usa.gov/1upG2Md), across 6 states, seems to have a monthly savings of $14 dollars (2% of total Parts A and B spending) per patient, compared with controls, a savings that actually turns negative when the costs of the program are included. The effects on quality are minimal, as well. Yet the underlying data present a far more interesting picture. Practices in New Jersey and Oklahoma have achieved savings of 5% to 7%, whereas those in Ohio, Kentucky, and Arkansas have seen their costs go up without much in the way of quality gains. Although it is possible that over time, some of these practices may recover, there are costs to waiting to see if that happens. The CMMI should seriously consider whether it wants to divert some of its resources to the successful practices or save them for other innovations, rather than continue to bet on failing efforts. It is true that sustainable change takes time, but organizations that struggle badly in the model in the first couple of years may themselves be better off in a different model of care delivery.