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To the Editor In their Viewpoint, 1 Dr Powers and colleagues analyzed 3 forces governing de-adoption of low-value care: evidence, eminence, and economics. A common denominator underlies them: the interest and convenience of the health care producers, providers, and purchasers. Fee-forservice creates strong incentives to continue delivering lowvalue but profitable care and technological abuse. 2 More generally, it incentivizes provision of services with a profitable differential between the production costs and the fee applied by purchasers. The production cost is physician-or hospital team–specific, based also on specific skills and preferences, whereas the applied fees are not hospital-or physicianspecific, further limiting targeted tariff policies. Aligned with pressure from patients and induced by technology producers and professional societies, fee-for-service multiplies outputs, which translates into financial …