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Healthcare business managers and financial leaders are chomping at the gainsharing bit now that the Department of Health and Human Services’ Office of Inspector General (OIG) released several favorable gainsharing advisory opinions. Still, experts advise hospitals and physician groups to proceed with caution. Gainsharing agreements are ripe for anti-kickback statute violations if done incorrectly. A gainsharing arrangement occurs when a hospital pays physicians a percentage of its savings attributable to changes in the physicians’ practice patterns (e.g., using standardized products, limiting use of supplies to "as needed," and substituting less costly items at their practices). The OIG recently offered several favorable advisory opinions, which providers may feel is open market to start gainsharing, says James Kopf, president of Healthcare Oversight, Inc., and former director of program investigations for the OIG. "But there is a limited window as far as what hospitals and physician groups can do," he says.