Most attention has been on the Supreme Court fight over The Affordable Care Act’s mandate to expand health insurance to 30 million more Americans. But what’s overshadowed is what the rest of the law is doing to change the business model for health care:

“The program launched in June 2009 with a checklist of quality metrics. To earn a bonus, surgeons would, among other things, need to ensure that antibiotics were administered an hour before surgery and halted 24 hours after, reducing the chances of costly complications.

“Only three doctors hit the metrics that first month, but their bonuses caught the attention of others. ‘There was a lot of, “Why are those doctors getting more, and I’m not?”‘ Zucker says. Eight doctors got bonus payments in July; two dozen got them in August. Compliance with certain quality metrics steadily climbed from 89 percent to 98 percent in three months.”