In 2013, The Center for Medicare and Medicaid Innovation launched the Bundled Payments for Care Improvement (BPCI) initiative, a program that proponents hoped could rein in health care costs by “bundling” payment for the full gamut of services that comprise an episode of care. The model certainly seemed like a good bet, as it would reward hospitals for reducing the cost of soup-to-nuts care for any of 48 conditions and penalize them for overruns. Indeed, bundled care for hip and knee replacement has been a dramatic success with clear savings and no increase in emergency department visits, readmissions, or 30-day mortality.