I believe each of the PCPs did benefit from the PCP performance despite the fact that there was a lot of of different levels of performances among the PCPs. Dr. Barney And Dr. Wells have achieved small referal gains and Dr. Fargo achieved a large referral gain, but Dr. Smith did a poor job of controlling speciality and hospital costs, producing a referral loss of $144,000. It does not seem fair that Dr. Smith was rewarded for the high performance of three phyisicans PCPs. A factor that should be investigated is mix of each PCP. Based on PCP performance, the single risk pool incentivizes the PCPs to manage referral costs effectively. When referral costs are less than what was budgeted for referral costs, the PCPs recevie some of the portion of the withhold back, this would than increase thier total compensation