Over the last couple of years there have been some high profile attempts at bundled payment.  The PROMETHEUS Payment® model has launched more bundles than any other program.  The story of the Medicare Bundled Payment for Care Initiative is still very much in development; and it is difficult to get information about what is going on in that program.  There have been some disputes based on a RAND Corporation evaluation of the Integrated Health Association (IHA) bundled payment project, which had decided to use a prospective payment model from the outset and garnered little enthusiasm from participants. The designers of the program took issue with RAND's assessment, offering, instead, lessons learned. A year earlier, the PROMETHEUS Payment® model had a similar experience with a negative RAND report based on outdated information. A later report found far better results, and offered lessons learned.  In the third annual report on non-federal bundled payment, the results were more impressive. Since the Medicare ACO Shared Savings Program still has participants leaving, and the value based payment modifier for hospitals does not demonstrate consequent increases in quality, it appears that bundled payment offers the best opportunity to drive process change and clinical integration between hospitals and physicians, as well as other providers.  It is for that reason that the announcement that HCI3 has published more than 80 Evidence-Informed Case Rates® that are available for free for public use is so important!! HCI3 is offering free webinars to help providers implement ECRs. The hard work of defining bundles has been done. There are now far fewer excuses for plans and providers not to move forward more widely on adopting bundled payment models.