Health-care economics has become a health-care reform, and reforming the American delivery of care has become a cultural and political movement. Historical presentation of the evolution of the current “fee-for-service” reimbursement methodology is based on resource-based relative value scale (RBRVS) and the impact it has had on the economics of care. An analysis of “key” areas of the Patient Protection and Affordable Care Act of 2010 and the impact it has had on “Physician Reimbursement Reform.” The focus on “Alternative Payment Models” has led to the current trend toward “clinical integration” of physicians into health-care networks. A section on “Alternative Payment Models” are evolving in the market place today. Finally, we include a section on contracting for surgeons who have finished residencies/fellowship programs or surgeons who are moving toward “integration” into health-care networks. An analysis of these compensation models is offered by these integrated networks in order to assist surgeons with insight into evaluating these contracts during negotiations.