For Advocate, pursuing shared savings was a more logical next step than gainsharing, says Mark Shields, MD, MBA, senior medical director for Advocate Physician Partners and vice president of medical management for Advocate Health Care.
"We decided organizationally that we were committed to being a population health company, and shared savings was going to be a part of that approach," he says. "Down the road, though, there may come a time when the shared savings model isn't generating the returns it is now, and then we'll need to look at our next steps."
Regardless of whether an organization opts for a gainsharing or shared savings approach, it still needs to demonstrate to the government not only cost savings but also improved (or at least steady) patient outcomes. So when deciding which path to take, Shields says one question is how much data an organization is interested and capable of tracking. In this light, gainsharing can be a transition step to shared savings, he says.
Lani Berman, vice president of performance services at Goodroe Healthcare Solutions, a consulting firm devoted to gainsharing, says that in the last two years she's seen a rise in interest in shared savings and gainsharing. "There are people that are setting up pay-for-performance models and shared saving models and blending in a gainsharing model," she notes. Goodroe is a subsidiary of VHA, a national network of nonprofit hospitals seeking supply chain savings.