A pilot pay for performance program conducted by CMS and Premier suggests that the use of evidence-based care is effective for many common conditions, further boosting the odds that the federal government will push forward with P4P rules that rival private sector efforts. In 2004, caregivers at 250 hospitals used 33 evidence-based clinical quality measures to treat common illnesses. The study found that the measures cut costs and improved outcomes for conditions such as heart attack, heart bypass, hip and knee replacements and pneumonia. On the other hand, heart failure patients who received the care experienced longer hospital stays, resulting in higher costs. Though the measures didn't work in all cases, Premier found there could be substantial benefit for enacting such a program. "…If all pneumonia, heart bypass, heart attack…and hip and knee replacement patients nationally received most or all (76 to 100 percent) of a set of widely accepted care processes in 2004, it could have resulted in nearly 5,700 fewer deaths; 8,100 fewer complications; 10,000 fewer readmissions; and 750,000 fewer days in the hospital. In addition, hospital costs could have been as much as $1.35 billion lower," the company stated in a press release. Congress is considering enacting a P4P program tied to Medicare in 2009.