March 2016 Presentations to Focus on Gainsharing’s Links to Performance Improvement
This March we will see gainsharing take center stage at two regional HFMA meetings, as well as presenting a poster at ACHE Congress. The events demonstrate the power of aligning the incentives of physicians and hospitals to drive physician engagement necessary to succeed under value based payment systems. The educational sessions will present case studies that show how organizations use gainsharing to not just reduce internal costs, but to improve quality.
On March 22, at HFMA Central Pennsylvania Chapter 10th Annual Hospital and Physician Collaborative at the Lancaster Convention Center in Lancaster, PA, I’ll be co-presenting with April Venable, Director of Population Health at Inspira Health Network (Vineland, NJ). Inspira needed to engage their physicians as they prepared for payments moving more toward value and away from fee-for-service, and saw gainsharing as a tool to help bridge the gap to the new payment models. Gainsharing served as a foundation for Inspira’s population health initiatives.
The Inspira experience is also being showcased at the American College of Healthcare Executives Congress on March 14-16, 2016 in Chicago. April Venable and AMS Vice President Anthony Stanowski will present a poster on the impact of gainsharing at Inspira Health Network. The poster provides a quick snapshot of the effectiveness of gainsharing in lowering costs, with savings realized on about 1 of every 3 dollars of cost opportunities in the last time period. After a start-up period, Inspira sees about $2 million in savings every 6 months.
More impressive though, is that the program worked hand-in-glove with Inspira’s care redesign protocols. Focusing on the Coach Program, Sepsis Work Flow, VTE Prophylaxis, Pneumonia Care, and Palliative Care, Inspira improved readmission rates, mortality, complications, length of stay, guideline adherence, core measure performance, as well as cost efficiencies.
On March 14, 2016, at the HFMA Western Pennsylvania Spring Institute at the Meadows Racetrack & Casino in Washington, PA, I will discuss “Using Gainsharing as a Foundation of Population Health Initiatives and Comprehensive Care for Joint Replacement (CJR)”. The session will introduce the Hospital and Healthsystem Association of Pennsylvania’s (HAP) state-wide gainsharing program – an initiative that facilitates the direct payment of incentives by hospitals to physicians to ultimately support clinical quality and operational efficiency goals.
I’ll review the program methodology, legal considerations, and experience in other states. The program’s success as a Medicare Demonstration program in New Jersey, and subsequently as Model 1 in the Bundled Payment for Care Initiatives led CMS to incorporate its’ principles into the CJR Model that will be implemented in select areas nationwide. Gainsharing’s incorporation into the CJR Model enables hospitals to align incentives for both reducing internal costs as well as reconciliation payments that may result from reducing Medicare payments,
Through these presentations, gainsharing can be seen as part of a larger effort to engage physicians and align the incentives of hospitals with physicians. Gainsharing is critical to the successful transition from volume to value. We are proud of our work that helped hospitals make the changes necessary to prepare for value-based payment.
We are on target to present at a couple more events this year, including at the inaugural HFMA Region 3 Summit on August 21 – 23 at the Mohegan Sun Pocono Resort, in Wilkes‐Barre, PA. We will inform you of those sessions as the schedules are confirmed.
Hope to see you at an upcoming event!
