Running Head: HEALTHCARE BARRIER 2Research has it that one of the main causes of health care high cost in many parts worldwide; along with the diverse serious quality problems in this field remains to be the way health care providers are being paid. “Notably, hospitals, physicians among other health care providers, under the existing payment system of fee-to-service are primarily paid on the services they deliver, but not on the basis of quality delivered or their effectiveness in enhancing the health of a patient. Unfortunately, it has even been observed that health care providers can actually be penalized financially for providing better quality services” (Miller, 2008). As a result,it has been widely agreed that significant transformations in the manner by which these providersare paid, remain to be necessary in reducing costs along with improving quality. On the contrary, even after this agreement, small proportion of payments made to health care providers nowadays are still based on quality or the value of care rather than the amount of services delivered. Significantly, this paper will explore the continued use of fee-for-service payment in payment reforms as one of the biggest barriers that providers, purchasers, buyers & even patients face in executing payment reforms, alongside showing the strategies for overcoming this barrier. Literature ReviewEvidently, several payment reforms don’t change fee-for-service payments, even though there has been a great acknowledgement of the serious problems with fee-for-service payment. One of the most common payment change that has been executed by Medicare along with many other commercial health plans currently remains to be shared savings (Rosen, 2012). In this approach of shared savings, the health care plans aims at paying providers by exactly using the same fees they nowadays receive for their services, then they pay a bonus or even impose a fiscalpenalty on the providers in cases where the total service cost for their patients is less or greater compared to the amount expected.