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I have a few PPA deals running and it works good for both me and the clients. They only pay for actions so they completely let me do my work, target the keywords I think is right, and generally do the things I know works. It gives me more freedom to work and it gives them a great deal of security because they practically only pay me a percentage of the increased profit I bring them.
Howver, tracking is still a big problem. Not that it can't be solved, it's just very pricy. I know there are some new solutions ready to hit the market but what I've seen in the cheap end of the market so far is just not good enough. At least, thats my personal experience :)