It's been tough to find a recent healthcare conference that doesn't have a presentation about physician gain-sharing. The ACHE's annual congress is no exception.
Physicians are eager to maximize their compensation without losing control of their practices. Meanwhile, hospitals are looking to cut costs, improve quality and cement their relationships with doctors.
Gain-sharing-whereby physicians are compensated for reducing hospital operating costs and improving quality-promises to satisfy everyone.
The idea has been used in manufacturing for years but only recently has been explored as a hospital-physician strategy, says veteran ACHE presenter Christopher Evans, vice president of HSG Management Services in Cary, N.C.
Compared with other industries, hospitals have a long way to go to improve their cost structures. Gain-sharing "is a wonderful way to begin," Evans says.
Evans and attorney Thomas Stukes, of Smith, Helms, Moore in Greensboro, N.C., will discuss some of the potential arrangements and their legal implications in a session titled "Physician Equity and Gain-sharing Arrangements," at 10 a.m. Monday, March 8, and again at 2 p.m. that day.
Gain-sharing offers particular promise in procedure-driven specialties such as cardiology, gastroenterology and surgery, in which costs can be easily identified, Evans says.
Once per-unit costs and revenues are analyzed, physicians who perform the most procedures can be found to be losing money, he says.
"A number of academic centers, such as the University of Virginia, have used a gain-sharing model with their clinical faculty," Evans says. "Academic centers are looking at it from a broad base of increasing clinical salaries."
With regulatory scrutiny of gain-sharing increasing, the seminar will stress the importance of obtaining objective data to justify physician compensation.
"A lot of people have held back (on gain-sharing programs) because of some of the regulatory issues that have been raised," Stukes says.
Equity-sharing arrangements such as joint ventures will also be discussed. Restrictive covenants-such as "lock-up" strategies, in which health systems obtain the right of first refusal to purchase practice assets-present antitrust issues but are an increasingly popular way for hospitals to partner with physicians in equity deals, Evans says.
In a separate presentation, Donald Buckley, president of Chesapeake (Va.) General Hospital, and Wynn Dixon, the hospital's vice president for human resources, will discuss their experience with a gain-sharing program for non-physician hospital employees. Their 20-minute session is titled "Gain-sharing Programs: The Key to Quality Improvement" and will be presented at 3: 35 p.m. Tuesday, March 9, and 3: 35 p.m. Wednesday, March 10.