This model depicts a process with exogenous inflows where the efficacy of the process descreases in proportion to time spent in the process. It is followed by a quality control mechanism with sensitivities and specificities which also decrease with time spent in the quality process. This bounded process and quality control is then checked against a gold standard which then adjusts as necessary in alignment with larger policy goals and feeds a larger data set. This model represents a realistic vision of what frontline quality control mechanisms should exist in the healthcare delivery system. It can be used as a tool for policy making to determine what acceptable rates of efficacy and outcome can be tolerated as quality based payments grow in popularity.