The caveat: Joint replacements might be a sweet spot for bundled payments. They might not work as well for other episodes of care.
The caveats: They may need to be part of larger programs to be effective. And smoking rates have fallen but remain stubbornly high among people without privilege.
The caveat: The evidence, though mainly positive, is mixed.
The caveats: Most of the evidence involves routine care. It is uncertain whether nurse practitioners will be willing to work in rural areas to fill the primary care void.
The caveats: P4P programs don’t have a great track record, and avoiding risky patients may prove to be an unintended consequence.