We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Commentary |

Bundling Our Health Care Future

Kenric M. Murayama, MD1
[+] Author Affiliations
1Department of Surgery, John A. Burns School of Medicine, University of Hawaii–Manoa, Honolulu
JAMA Surg. 2015;150(12):1115-1116. doi:10.1001/jamasurg.2015.2422.
Text Size: A A A
Published online


Proponents of a movement away from the traditional fee-for-service model of reimbursement for health care argue that it results in unnecessary use of services and interventions by rewarding volume and not value, increasing the cost of care. In 1984, Medicare instituted the diagnostic-related group model in an effort to stabilize health care costs by decreasing length of stay and resource use in the inpatient setting; however, postacute care was not included and outpatient spending increased as patients were discharged earlier.1 The Patient Protection and Affordable Care Act of 2010 established incentives for hospitals and physicians to improve value and address outcomes.1 A result of this was the Bundled Payment Care Improvement Program, exploring a bundled payment model that began in January 2013 and targeted all Medicare fee-for-service beneficiaries with Part A (hospital) and part B (physician) coverage.2 The bundling of payments resulting in a single reimbursement for all services rendered by health care professionals for an episode of care has been proposed as a potential health care reform solution. An episode of care is defined as all acute and postacute care provided for a particular patient condition including physician payments and the costs of postdischarge care for a specified amount of time.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles