In the past two years, many hospitals have experienced low or negative operating margins, difficulty accessing capital, and the need to reduce spending to conserve cash. This has occurred before any effects of the $938 billion Healthcare Reform bill, 16% of which is to be funded by revenue cuts to hospitals. The Hospital Performance Alliance is a consortium of proven specialists whose mission is to help hospital leaders prepare for the future by driving both revenue optimization and broad-based cost reduction. Projects can be implemented on a “pay-for-performance" basis without fixed fees, eliminating the financial risk to the hospital.