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Robert C. Leif 9:08pm May 3, 2012This type of partnering should permit the SignatureValue Alliance to act as an HMO and thus become the insurer of its patients. Considerable cost savings should result from the disintermediation of the conventional health insurance companies by having the US Government directly pay the health care provider. There is the risk in this direct payment approach of the health care provider having a strong financial incentive to minimize costs by reducing its quality of service.