Medicare hopes it can save money by the bundle. As a result of the Patient Protection and Affordable Care Act, Medicare soon will be required to test a bundled-payment approach to reimburse for care. The reason for the push for “bundling” in Medicare is the belief that the current system promotes unnecessary spending growth because it rewards volume of services regardless of the appropriateness, cost and quality of those services. Payment is made for each unit of service. For example, Medicare makes multiple separate payments for services associated with a complex medical procedure performed in a hospital, such as multiple providers involved in the patient's care. Under bundling, a single payment is made for a group of services related to an episode of care involving multiple providers and care settings. The principle is that bundling should promote closer integration of healthcare providers and hold them jointly responsible for the cost and quality of care. Bundled-payment approaches are already in use in the private sector, and some studies of these payments suggest that for certain services and in certain settings, bundling can lower costs, improve efficiency and even improve outcomes. The Affordable Care Act requires the national bundling demo to begin in 2013.