One concern about “bundled care” as a payment method is that while it could lower costs per episode of care, it could perversely encourage hospitals to perform more procedures overall or change their case mix by cherry-picking patients who may have lower risks. However, Commonwealth Fund–supported researchers writing in the Journal of the American Medical Association found that hospitals participating in a Medicare bundled care model did not perform significantly more surgeries for lower extremity joint replacement. The researchers also found the program was generally not leading hospitals to change their case mix in a bid to avoid higher-risk patients.
