In compliance with Item 475.G.7. of the 2018 Appropriation Act, the Department of Human Resource Management (DHRM) submitted a report on the Musculoskeletal (MSK) Bundled Payment Pilot Program in August 2018 [RD262 (2018)]. However, at that point, the duration of the pilot period had been relatively short, and limited credible data were compiled. The report did not provide a clear determination as to whether bundling was effective. In an effort to better assess the effectiveness of the pilot program, DHRM continued the study and prepared this is additional updated report, which addresses data through June 30, 2019.