ɪn tˈuː θˈaʊzənd nˈaɪn, mˌæsɐtʃˈuːsɪts, wɪððə hˈaɪɪst hˈɛlθ kˈɛɹ kˈɔsts ɪnðə kˈʌntɹi, hæd ɐ ɡɹˈuːp ʌv tˈɛn hˈɛlθ kˈɛɹ ˈɛkspɜːts hˌuː wˈɜːkt ˌʌndɚ lˈɛdʒɪslətˌɪv mˈændeɪt tə kˈʌm ˌʌp wɪð ɐ plˈæn tə tˈækəl kˈɔsts ðə mˌæsɐtʃˈuːsɪts pˈeɪmənt ɹᵻfˈɔːɹm kəmˈɪʃən; ðeɪ juːnˈænɪməsli kəŋklˈuːdᵻd ðɪ ˌɛfˌɛfˈɛs mˈɑːdəl mˈʌst biː dˈʌn ɐwˈeɪ wɪð.
In 2009, Massachusetts, with the highest health care costs in the country, had a group of ten health care experts who worked under legislative mandate to come up with a plan to tackle costs (the Massachusetts Payment Reform Commission); they unanimously concluded the FFS model must be done away with.