ɪn ɐdˈɪʃən tə ðə mˈeɪoʊ klˈɪnɪk, ˈʌðɚ hˈɛlθ kˈɛɹ sˈɪstəmz sˈɜːv æz kˈoʊˈɔːɹdᵻnəɾᵻd slˈæʃ ˈɪntᵻɡɹˌeɪɾᵻd kˈɛɹ ɔːltˈɜːnətˌɪvz tə ðɪ ˌɛfˌɛfˈɛs mˈɑːdəl lˈaɪk sˈaʊθ sˈɛntɹəl pˌɛnsɪlvˈeɪniəz dʒˈeɪsɪŋɚ hˈɛlθ sˈɪstəm hˌuːz fɪzˈɪʃənz, ɹˈɛzᵻdənts ænd fˈɛloʊz ɑːɹ pˈeɪd ɐ sˈælɚɹi wɪððə pətˈɛnʃəl fɔːɹ bˈoʊnəsᵻz dᵻpˈɛndɪŋ əpˌɑːn pˈeɪʃənt pɚfˈoːɹməns, jˈuːtɔz ˌɪntɚmˈaʊntɪn hˈɛlθkɛɹ, ðə klˈiːvlənd klˈɪnɪk, ænd kˈaɪzɚ pˈɜːmənˌɛnt.
In addition to the Mayo Clinic, other health care systems serve as co-ordinated/integrated care alternatives to the FFS model like South Central Pennsylvania's Geisinger Health System whose physicians, residents and fellows are paid a salary with the potential for bonuses depending upon patient performance, Utah's Intermountain Healthcare, the Cleveland Clinic, and Kaiser Permanente.