Bundled payment models hold the promise of driving down health care costs while improving health care quality. As pilot projects have been conducted in the field, common barriers and themes have emerged, including administrative implementation hurdles, data and technology challenges, new emphasis on engaging patients in their care, and questions of whether true costs savings can realistically be achieved. This brief addresses the successes and challenges encountered in a recent bundled payment pilot project in Wisconsin, as well as the underlying transformative effects on patient care.