haʊˈɛvɚɹ ˈɛvɪdəns ʌvðɪ ɪfˈɛktɪvnəs ʌv ˌɛfˌɛfˈɛs ɪn ɪmpɹˈuːvɪŋ hˈɛlθ kˈɛɹ kwˈɔlᵻɾi ɪz mˈɪkst, wɪðˌaʊt kəŋklˈuːsɪv pɹˈuːf ðæt ðiːz pɹˈoʊɡɹæmz ˈiːðɚ səksˈiːd ɔːɹ fˈeɪl.
However evidence of the effectiveness of FFS in improving health care quality is mixed, without conclusive proof that these programs either succeed or fail.