Ask the expert: What is gainsharing?

Gainsharing is an approach in which a specific group of physicians does something that creates financial savings for a hospital, and the hospital shares a portion of those savings with the physicians. Physicians can create savings for hospitals in a number of ways, including:

• Shortening length of stay
• Agreeing to the use of a single manufacturer for implants
• Reducing unnecessary testing and other ancillary services
   

Physicians and hospitals have been attracted to gainsharing ever since DRGs put hospitals at risk for physician practice patterns. It makes sense to physicians: if they do extra work to get patients out of the hospital faster, such as rounding twice in the same day, they should receive a cut of those savings. Similarly, hospitals benefit from gainsharing as they achieve cost and quality improvements from physicians invested in the success of these changes.

Despite the benefits, some laws have made gainsharing illegal, specifically Stark laws, the anti-kickback statute, and the civil monetary penalties law.

This week’s question and answer are from The Greeley Guide to New Medical Staff Models: Solutions for Changing Physician-Hospital Relations by Richard A. Sheff, MD, CMSL, and William K. Cors, MD, MMM, FACPE, CMSL.