ðə mˈɛdɪkˌɛɹ pˈeɪmənt ɐdvˈaɪzɚɹi kəmˈɪʃən mˈɛd pˌiːˌeɪsˈiː, ɪn ɪts mˈɪd tˈuː θˈaʊzənd ɪlˈɛvən ɹᵻpˈoːɹt tə kˈɑːŋɡɹəs, kˈɔːld fɚɹə mˈɛkənˌɪzəm sˌoʊ ðæt mˈɛdɪkˌɛɹ bˌɛnɪfˈɪʃɚɹiz wʊdhɐv dˌɪsɪnsˈɛntɪvz tʊ ˌʌndɚɡˈoʊ ʌnnˈɛsᵻsɚɹi kˈɛɹ.
The Medicare Payment Advisory Commission (MedPAC), in its mid-2011 report to Congress, called for a mechanism so that Medicare beneficiaries would have disincentives to undergo unnecessary care.