Sharing the Wealth, Gain-sharing Arrangements Put Physicians on Top in Finding

By Bonnie Darves. With reimbursement at rock-bottom levels and costs continuing to rise, hospitals are turning to the once untapped source for help in staying profitable: the physicians who directly or indirectly controls an estimated 75 to 80 percent of hospital spending. What the hospitals are seeking, and are willing to pay for, is intellectual expertise aimed at reducing the cost of big-ticket services such as open-heart surgery.. Typically referred to as gain-sharing, these arrangements essentially amount to consulting deals where physicians identify or process improvements or practice standardizations that could save the hospital money. If the initiative pays off — reducing per-case costs without compromising quality of care — the physician "consultants" get a portion of the savings. The areas typically targeted are procedure driven: cardiology, orthopedics, oncology, and obstetrics.. Everyone’s doing it. Atlanta attorney Tobin Watt calls hospital-physician gain-sharing a "hot button issue in health care" that is likely to become a major trend soon — provided the attendant legal issues are sorted out. In particular, hospitals and physicians are waiting for such deals to pass muster with the Health Care Financing Administration, the Office of Inspector General, and the IRS before "going public" with gain-sharing arrangements. "Hospitals have ...

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