BPCI - Time to pull the plug?

In an article by the Kaiser Family Foundation titled "What's the Evidence on Savings and Quality in Medicare Payment Models?" they share a side-by-side comparison which shows that under BPCI Model 1, very little financial or quality impact was made, and they state "notably, Medicare spending on care following hospitalizations was higher for BPCI episodes than the comparison group. Most hospital participants withdrew".

Under Model 2 they share, "in the first two years, relative to comparison groups, the Model 2 BPCI participants had statistically significant Medicare savings per 90-day episode for 1 of 23 clinical groups (major joint replacement of lower extremities—mostly hip and knee). No statistical difference in other 22 clinical groups."

Under Model 3 the study finds that "in the first two years, relative to comparison groups, Model 3 BPCI participants had statistically significant Medicare savings per 90-day episode for 2 of 14 clinical groups (major joint replacement of lower extremities—mostly hip and knee—and congestive heart failure). No statistical difference in other 12 clinical groups."

What isn't even mentioned here are the enormous costs to providers to actually deliver these results, as anemic as they are. Considering all the care management, care navigator, and administrative positions created in many of the participating hospitals to try and drive these outcomes, it is no wonder so many of them withdrew.

While bundled payments may have bipartisan and bicameral support, do the results actually justify moving forward with new bundles? Is the thought that the new bundles would address shortcomings found in the first round and improve results for the next go round? With these results, it would seem the original program was, although a worthy effort, ultimately a colossal failure.

Not sure what the answer is, but BPCI doesn't seem to be it.