these include improving quality information to enable performancebased contracting creating room for providers and health insurers to develop alternative payment methods based on performance and financial risksharing eg riskadjusted capitation payments and allowing limited vertical integration of health insurers and providers in addition hospitals access to capital markets could be expanded by revoking their mandatory nonprofit status a move that should be accompanied with measures to secure the orderly exit of bankrupt hospitals notably in terms of providing essential services and to ensure an effective and transparent merger control they could also encourage patients to make choices that take price and quality into consideration