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Gainsharing: past, present, and future.

Anjana D Patel¹

¹Sills Cummis Epstein and Gross P.C., Newark, NJ, USA. apatel@sillscummis.com

Healthcare Financial Management : Journal of the Healthcare Financial Management Association

|September 19, 2006

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Gainsharing programs align hospital and physician financial interests to enhance patient care quality and operational efficiency. Approved gainsharing models focus on specific, measurable actions and cost savings, making them viable for hospitals again.

Area of Science:

Healthcare Management
Health Economics
Quality Improvement

Background:

Hospitals and physicians often have misaligned economic incentives.
Gainsharing offers a framework to align these interests.
Previous regulatory uncertainty impacted gainsharing adoption.

Purpose of the Study:

To explore the potential of gainsharing arrangements in healthcare.
To analyze the implications of the Office of Inspector General's (OIG) 2005 advisory opinions on gainsharing.
To identify characteristics of gainsharing models likely to receive OIG approval.

Main Methods:

Review of OIG advisory opinions and relevant literature on gainsharing.
Analysis of the conditions under which gainsharing arrangements may be permissible.

Related Experiment Videos

Examination of the link between gainsharing and operational efficiencies/quality improvement.

Main Results:

Gainsharing can align economic interests between hospitals and physicians.
The OIG's 2005 opinions signal renewed consideration of gainsharing by hospitals.
Approved gainsharing arrangements are characterized by specificity, identifiability, and verifiability of actions and cost savings.

Conclusions:

Gainsharing presents an opportunity for hospitals to improve efficiency and quality.
Carefully designed gainsharing programs, focused on specific outcomes, are likely to be compliant.
Hospitals can consider implementing gainsharing following OIG guidance.