The Applied Medical Software Performance Based Incentive System® (AMS PBIS®) is a comprehensive approach for measuring and rewarding inpatient physician performance – i.e., costs per case adjusted for case-mix and severity of illness and is the cornerstone of the AMS Gainsharing Program. AMS PBIS® recognizes both “performance”, a physician’s adjusted costs per case compared with his/her peers, and “improvement”, a physician’s performance compared with his/her own performance over time. The AMS PBIS® is the methodology used in the largest gainsharing demonstration approved by Medicare. It currently also is utilized in several commercial gainsharing programs. AMS PBIS® is protected by patent.