Lessons Learned from a Hospital-Physician Gainsharing Program

This month, hfm Magazine explores “Lessons Learned from a Hospital-Physician Gainsharing Program, examining the experiences of the New Jersey Hospital Association, the Greater New York Hospital Association, and their member hospitals. NJHA’s SVP Sean Hopkins, AMS VP Anthony Stanowski, and I discuss the leadership lessons learned using the 8-step process for leading change advanced in the seminal 1996 book, Leading Change by Dr. John Kotter, Emeritus Professor of Harvard Business School.

By documenting the key lessons learned from the associations that administered gainsharing programs and the hospitals that implemented them, we hope that this article provides guidance to health care providers not just in implementing gainsharing programs, but also as they undergo the change management process for other forms of alternative payment systems.

For example, escalating healthcare costs can only be resolved by aligning provider interests under a common vision. Physicians and hospitals need to work together.  Kotter’s third step, “Develop a strategic vision” shows how gainsharing establishes a framework to align the overall vision of hospitals and physicians.  NJHA clearly spelled out a vision: “To enhance the quality of patient care through commitments to care redesign and quality initiatives; and to reduce the cost of care by eliminating medically unnecessary services.” The association invested in a process designed to meet the concerns of regulators, hospitals, and physicians. This included using standardized data to develop best practice norms, tracking quality measures as determined by the hospital and medical staff, and focused internal discussion.  The results were clear: the 12 hospitals in the NJ Medicare Demonstration Project saved nearly $113 million over three years.

To read the entire article, which details how Kotter’s 8 stages for creating major change are defined within a gainsharing program, click here.