|Gainsharing: Aligning Incentives For Physicians And Hospitals
Twelve New Jersey hospitals, Beth Israel Medical Center
in New York City and Charleston Area Medical Center in West Virginia,
are participating in the Gainsharing Demonstration, along with more
than 1,000 physicians working at those three hospitals.
The program is evaluating gainsharing as a means of
aligning incentives between hospitals and physicians to improve quality
of care and overall hospital efficiency.
The idea is to break the iron grip of fixed hospital payments and fee-per-procedure that physicians now receive.
"This is a bold test to see if we can redesign the
failed system of the past and replace it with strategies that keep
healthcare affordable while making it better and safer for patients,"
said Betsy Ryan, president and CEO of the New Jersey Hospital
Association (NJHA). "That’s essential as we embark on a national
effort to reform our healthcare system."
The demonstration is designed to track patients beyond a
hospital episode to discharge to determine the impact of
hospital-physician collaborations on preventing short- and long-term
complications and duplication of services.
Gainsharing is designed to encourage physicians and
hospitals to work together to provide the most efficient care for
patients, and offers physicians financial incentives to work with
hospitals in lowering costs in a variety of ways. The program also
includes stringent quality controls to protect patients.
"It’s a simple, elegant idea to align incentives
of doctors and hospitals – all with the ultimate goal of creating
a better healthcare outcome for the patient and eliminating unnecessary
costs from our healthcare system," said Michael Kalison, chairman of
Applied Medical Software, who worked with NJHA to design the pilot
For additional information on VBP demonstrations, visit www.cms.hhs.gov/DemoProjectsEvalRpts/MD/list.asp.