Actual outcome data can be difficult to obtain and even if results are tracked, it is difficult to account for other factors that influence treatment effectiveness and patient outcomes. In addition, paying agencies often focus less on certain treatment outcomes than on reducing total medical costs over time. For most, if not all, paying agencies, another hurdle for BBVs may be the systems that support reimbursement – which are based on the implicit model that you pay for therapy on the first day and that you concluded with that transaction. . . .