" competition takes place on discrete interventions rather than the full cycle of care where value is determined. Value can only be measured over the care cycle, not for an individual procedure, service, office visit, or test. Yet care is structured around medical specialties and discrete services, not the integrated care of medical conditions. Physicians act as free agents, performing their specialty and billing separately. Navigating the care cycle is challenging. Nobody takes an overall care-cycle perspective, including steps to avoid the need for interventions (prevention) and ongoing management of medical conditions to forestall recurrence (disease management). "

― Michael E. Porter , Redefining Health Care: Creating Value-based Competition on Results