ACHE-NJ Innovation Award to be Shared by NJHA and AMS Share for Implementation of Gainsharing Program

On January 30, 2015, at the American College of Healthcare Executives-NJ Chapter breakfast session, preceding the New Jersey Hospital Association 96th Annual Meeting, Awards & Luncheon, the ACHE Regent Award for Innovation was awarded to NJHA and to AMS for the creation of a gainsharing program.  ACHE-NJ recognized this pioneering initiative to improve healthcare value and reduce costs by promoting better coordination and collaboration among New Jersey hospitals and physicians.

The program was initially proposed to Medicare by NJHA and AMS in 1999 as a demonstration project. Following a 5 year period working through implementation issues, and an additional 5 years that required regulatory approval by Congress, the Medicare Gainsharing Demonstration began in 2009 with 12 NJ hospitals.  A July 2014 AHRQ Health Care Innovations Exchange Profile noted that total savings for the demonstration project reached nearly $113 million, and performance on quality measures either remained the same or improved throughout the program.  Based on this success, NJHA secured CMS approval for a second, larger gainsharing demonstration (known as “Model 1”) under the Affordable Care Act’s Bundled Payments for Care Improvement initiative in 2013, which expanded the program to 23 hospitals. New Jersey’s proven success in gainsharing generated much interest from hospital associations and large health systems.  The Greater New York Hospital Association adopted a version of the gainsharing program in 2010 for commercial patients, as did, the Hospital and Health Association of Pennsylvania in 2014. The Maryland Hospital Association is planning implementation in 2015 as part of its all-payor waiver. Integris Health in Oklahoma is also in the process of implementing gainsharing as part of it clinical integration strategy.

Betsy Ryan accepting award from Michael Friedberg, Chair, ACHE-NJ Awards Committee.

In accepting the award on behalf of NJHA, NJHA President and CEO Betsy Ryan said: “Healthcare is changing – no question – and New Jersey hospitals are committed to being leaders in that change. It’s an honor to have ACHE recognize this work – and even more rewarding to know that the commitment and hard work of New Jersey hospitals is now serving as a national model for improving healthcare value.” Sean Hopkins, Senior Vice President – Health Economics at NJHA, who served as Gainsharing Demonstration Project Manager, added: “Seeing the gainsharing model produce the ‘triple aim’ outcomes of better health and lower costs through coordinated care has been professionally rewarding. The hospitals should all be commended for their foresight and willingness to carve a path that has become a national model for provider collaboration, and CMS should be applauded for allowing creative ideas like this to have the opportunity to be field-tested in the real world.”

Michael Friedberg, Betsy Ryan, Jo Surpin and Sean Hopkins.

The award recognizes that gainsharing is a tool to engage physicians and provides the foundation to align provider incentives under a common goal.  We are excited that the gainsharing work done in New Jersey can serve as a model throughout the country and help to achieve more efficient care and improve quality. All of us at AMS are very proud of this honor. The success of this initiative could not have been achieved without the partnership between NJHA and AMS.  We are indeed privileged to be sharing the award with our longstanding partner NJHA.