DOJ to Allow Greater New York Hospital Association’s Proposed Gainsharing Program

January 23, 2013 | Risk Management News

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The U.S. Department of Justice (DOJ) has decided not to challenge a gainsharing program proposed by the Greater New York Hospital Association, states a January 16, 2013, business review letter from DOJ to the association’s counsel. Under the program, the association would reward physicians from its approximately 100 hospitals with a share of the savings generated from reducing costs for treating commercial health insurance and Medicaid and Medicare managed care patients if the physicians meet hospital-specific quality standards. Although the proposal implicates antitrust issues, DOJ determined that the proposed program would not adversely affect competition, because the participating hospitals will not exchange any confidential information and because each hospital will independently determine physician gainsharing amounts.

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