Back in 2011, officials at Seton Health Alliance were anxious to change the way its doctors delivered health care. The Austin-based hospital system didn't want to get paid just for the sheer volume of surgeries and patient visits their doctors delivered. Executives wanted to try something new: They wanted Medicare to pay them for taking better care of patients. Seton Health also wanted to move as quickly as possible. So in December 2011, it became a Pioneer Accountable Care Organization, one of 32 health systems across the country that would — as the name implies — pioneer value-based care, and get paid for hitting certain quality metrics.