a wordBundled payment

One payment covering everything a patient needs for a defined episode — the admission, the surgeon, the rehabilitation, the readmission if it happens — across every provider involved, for a fixed number of days after discharge. Providers who spend less than the target keep the difference; those who spend more absorb it.

The American programmes are where the shape can be read, because each one published its own window. Under Bundled Payments for Care Improvement, whose first awardees began in April 2013 and whose later models began that October, Model 1 defined the episode as "the inpatient stay in the acute care hospital" and Model 2 as the inpatient stay "plus the post-acute care and all related services up to 90 days post-hospital discharge". BPCI Advanced, from 1 October 2018, defined it as "the Anchor Stay plus 90 days beginning the day of discharge or the Anchor Procedure plus 90 days beginning on the day of completion of the outpatient procedure". Comprehensive Care for Joint Replacement ran from 1 April 2016 to 31 December 2024 on a 90-day episode. The Transforming Episode Accountability Model, mandatory for selected hospitals, runs from 1 January 2026 to 31 December 2030 across five surgical categories — and its episode is shorter: "Each episode will end 30 days after the individual leaves the hospital."

Inference — the window is the whole design. A 90-day bundle makes the readmission the payer's problem and the hospital's risk; a 30-day bundle moves the same complication outside the payment. Nothing about the clinical course changed between the two models.

A bundle is an arrangement between a payer and providers, not a price offered to a patient. Its exclusions are published separately from its definition, in technical lists of clinical episode exclusions rather than on the face of the model. Nothing in it crosses a border: a patient treated abroad is outside every episode any of these programmes defines.

As of 17 September 2026 no record on this site carries a bundled payment as a price. The term appears here because it is the payer-side relative of the package a foreign hospital sells, and the comparison between them is the clearest way to see what a package leaves out.