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Comment & Response
January 1/8, 2019

Potential Unintended Effects of Medicare’s Bundled Payments for Care Improvement Program

Author Affiliations
  • 1Interfaculty Initiative in Health Policy, Harvard Graduate School of Arts and Sciences, Cambridge, Massachusetts
  • 2Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
JAMA. 2019;321(1):106. doi:10.1001/jama.2018.18158

To the Editor Dr Navathe and colleagues studied whether Medicare’s Bundled Payments for Care Improvement (BPCI) program led to unintended consequences, including changes in volume and case mix.1 Based on an estimated differential change in market volume between participating and nonparticipating markets of 0.32% (95% CI, −0.06% to 0.69%; P = .10), they concluded that BPCI participation “was not associated with changes in market-level lower extremity joint replacement volume.” This conclusion has statistical and practical problems.