The pay-for-performance (P4P) model, which allows hospitals and physicians to be compensated with higher payer reimbursement for providing documented quality care, is becoming a standard practice with a growing number of private insurers, and the federal government wants to use a P4P system for Medicare.

Often overlooked in the debate over who's going to win the Internet wars, Cardinal makes its case for a distributor-driven model. A single place to purchase drugs and med/surg supplies, do remote order entry, and more efficiently process information, Cardinal.com builds off of traditional EDI programs. Like many e-commerce plays, Cardinal.com recognizes the value of an open system and the ability to work with as wide a variety of sites as the customer wants. But company officials make a distinction between a stance of openness and neutrality. In the process, Cardinal is trying to make the argument that rather than being disintermediated by the new B2B players, distribution-based models may ultimately prove the most robust and sustainable because of distributors' history of supply chain management.