DOJ Will Not Challenge New York Hospital Association Gainsharing Program
Jan. 17 — The U.S. Department of Justice will not challenge a proposal by the Greater New York Hospital Association to offer a gainsharing program to member hospitals in New York, the DOJ said in a release. According to the DOJ, the proposed program should not adversely affect competition because hospitals will not exchange any confidential information and because each hospital will independently determine physician gainsharing amounts.
Under the gainsharing program, physicians could receive a share of the savings generated from reducing costs for treating commercial health insurance patients and for Medicaid and Medicare managed care patients if the physicians meet hospital-specific quality standards.
The Greater New York Hospital Association is a trade association of hospitals and continuing care facilities in New York and nearby states. The hospital association proposes to make a voluntary gainsharing program available to its 100 New York-area hospitals.
Using publicly available and historical patient discharge data, an independent contractor of the hospital association will calculate a statewide best practice norm for certain groups of treatments or procedures. The contractor will then use the data to measure the performance of individual physicians practicing at the participating hospitals relative to the best practice norm.
According to the DOJ, the proposed information-sharing program outlined by the hospital association is unlikely to facilitate collusion or otherwise raise competitive concerns.
Publication Date: Thursday, January 17, 2013