If you've watched the news or listened to politicians at all in the last 10 years or so, you've heard about how much health-care costs have risen. Heck, if you've been to the doctor in the last 10 years and written a check for the co-pay, you probably know what I'm talking about. And it's hard to argue that it's been all bad. Certainly medical device and drug companies don't mind, and health plan providers such as UnitedHealth (NYSE:UNH) and Coventry (NYSE:CVH) aren't exactly crying either.

And then we have Motley Fool Stock Advisor recommendation American Healthways (NASDAQ:AMHC), which is mostly concerned with finding ways to improve patient compliance and care and reduce the total cost burden while improving outcomes. So far, so good. Growth was again good in the fourth quarter, as revenue climbed 22% along with a 41% increase in people under management. While as-reported earnings fell from the year-ago period, the company did incur more start-up costs for its Medicare health support pilot studies. Stripping those out, earnings per share rose about 15%.

Speaking of those pilots, it looks like they're off to a good start. In the Maryland/District of Columbia pilot, the company has already engaged more than two-thirds of the target population (about 20,000 diabetes and congestive heart failure patients), and it took just 70 days for the company to achieve its "critical mass" target of 69%.

Only time will tell for sure, but I think this pilot could be very successful for the company. Diabetes and congestive heart failure are both difficult to manage, and I think there's a great opportunity for American Healthways to show the cost benefits of its service of coordinating with patients, doctors, and health plans to improve patient care results.

Elsewhere, American Healthways is about to get under way with another pilot in Georgia in conjunction with CIGNA (NYSE:CI).

There's no doubt that the health-care market is in flux. For instance, WellPoint (NYSE:WLP) recently announced that it was acquiring WellChoice (NYSE:WC), an American Healthways client. Management seems confident that its demonstrated performance will keep it in place there, but when the pieces on the board start moving around, the risks to shareholders can go up.

I'm still holding on to the vain hope that I'll get the chance to pick these shares up after a market freak-out makes them cheaper. I know I'm missing a good growth opportunity by standing on the sidelines, but my inner Buffett still quails at the thought of paying more than 30 times forward earnings.

For more healthful Takes:

UnitedHealth and Coventry are also Motley Fool Stock Advisor recommendations. For more investing advice from Tom and David Gardner, click here.

Fool contributor Stephen Simpson has no financial interest in any stocks mentioned (that means he's neither long nor short the shares).