Medicare is testing new ways to encourage providers to keep down costs, improve quality of care, and increase accountability. One program, the Bundled Payments for Care Improvement (BPCI) initiative, pays participating hospitals not for each service they provide to a patient but for the entire "bundle" of services included in an episode of care -- whether it's a surgical procedure or hospital treatment for a chronic medical condition. While bundled payments applied to surgical procedures have yielded promising results, a Commonwealth Fund-supported study led by Karen E. Joynt Maddox, M.D., of the Washington University School of Medicine indicates that, so far, they don't appear to be producing comparable benefits for chronic medical conditions such as heart disease.