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Comment & Response
June 14, 2016

Medicare’s Bundled Payment Program and Health Care Utilization

Author Affiliations
  • 1Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
JAMA. 2016;315(22):2470-2471. doi:10.1001/jama.2016.3815

To the Editor Dr Press and colleagues1 described Medicare’s bundled payment program and acknowledged that the program may incentivize inappropriate overuse, restrict care to certain (presumably low-risk) groups, and shift care outside the episode—unintended consequences of bundled payment reimbursement strategies that have been raised before.2 But implementing bundled payments without requiring processes that “incorporate shared decision making, patient-reported outcomes, and clinical appropriateness”1 is a recipe for overuse and cost escalation.

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