Related Experiment Videos
Gainsharing: a cost-reduction strategy that may be back.
1Health Law Practice Group, ShawPittman LLP, Washington, DC, USA. max.reynolds@shawpittman.com
Summary
The HHS Office of Inspector General (OIG) now permits gainsharing arrangements between hospitals and physicians, provided safeguards prevent fraud and abuse. Careful consideration of existing federal laws is crucial for structuring these initiatives.
Area of Science:
- Healthcare Law
- Health Economics
- Healthcare Management
Background:
- The Health and Human Services Office of Inspector General (HHS-OIG) previously prohibited gainsharing arrangements.
- Gainsharing involves financial incentives for healthcare providers to reduce costs.
Purpose of the Study:
- To analyze the HHS-OIG's revised stance on gainsharing arrangements.
- To inform hospitals and physician groups about opportunities and limitations related to gainsharing.
Main Methods:
- Review of HHS-OIG Advisory Opinion 01-1.
- Analysis of existing federal laws governing healthcare fraud and abuse.
Main Results:
- The HHS-OIG has approved a gainsharing arrangement under specific conditions.
- Approval was contingent upon implementing safeguards against Federal healthcare program fraud and abuse.
Conclusions:
- Hospitals can now explore gainsharing with physicians, focusing on operating expense reduction.
- Structuring gainsharing initiatives requires careful consideration of legal limitations and safeguards.