National and private sector global payment systems are needed to improve our inefficient and costly U.S. health care system, according to industry health care officials. Under the current model, fee-for-service payment includes charges specific to every medical visit, procedure, and test a patient receives. Payment reform in Medicare is underway, and promising cost savings are emerging from Accountable Care Organizations (ACOs), Medical Homes, and other bundled payment systems. Preventative and evidence-based treatments are utilized to reduce costs. Leaders such as Elliott Fisher, MD, MPH, Director of the Dartmouth Institute for Health Policy & Clinical Practice, suggests government aid is needed to further refine the most efficient structures and policies: "There are hundreds of ACOs and we're surveying them for information, but it's not a systematic effort supported by the government to learn as rapidly as we can what works and what doesn't.” Others, such as Ron Pollack, Executive Director of a health care advocacy group called Families USA, stated at last week’s Partnership for Sustainable Health Care meeting that seeking state support, aside from federal funds, will quicken the pace of payment reform. Despite these recent successes, dissent remains among industry officials as to how and when systems will be ready to begin implementing more widespread health care finance reform.