The battle of the bundle: What I learned from my mother’s partial hip replacement


Timothy Hoff, D’Amore-McKim School of Business Professor of Management, Healthcare Systems, and Health Policy, is featured in the August issue of Health Affairs

Timothy Hoff, D’Amore-McKim School of Business Professor of Management, Healthcare Systems, and Health Policy, is featured in the August issue of Health Affairs, a leading journal covering the intersection of health, healthcare, and health policy. His article, “The Battle of the Bundle: What I Learned from My Mother’s Partial Hip Replacement,” details his family’s experience with Medicare’s bundled payment program and the impact it has had on his view of the Centers for Medicare and Medicaid Services.

The Medicare bundle payment program Hoff’s family experienced was a pilot program created in 2016 by the Centers for Medicare and Medicaid Services. If the total cost of care exceeded a certain amount after a patient has been discharged, the program placed the financial risk on the hospitals to pay for it.

Hoff did not know his mother was going to be a participant in the bundle program, which quickly came to feel like an “assembly line” of care during her surgery, aftercare and recovery.

“Sure, it sounds like it makes sense clinically: Get them up quick and get them moving. But the speed with which things started happening struck my siblings and me as less than ideal,” Hoff said in the article. “It also made me wonder, looking back, if there wasn’t some conflict of interest on the hospital’s part— regardless of the clinical appropriateness of what happened to my mother— given her membership in this new bundled payment program, which seems to encourage hospitals to move joint replacement patients quickly to somewhere else.”

Read more about Hoff’s experience here or listen to the podcast version.