Physician Payment and Reimbursement
Ask the Experts: CJR Physician Gain Sharing Agreements
April 12, 2018
9:37 am
We are a full-service hospital but primarily focus on elective orthopedic and spinal procedures. In 2017, we were recognized by the Comprehensive Care for Joint Replacement (CJR) program and awarded with funds for the prior year’s performance. We did not have a formalized agreement in place with our physicians prior to the launch of the program and were therefore not allowed to share these funds. We’ve researched the program and the requirements of how to design the gain sharing agreement, based on quality metrics versus volume, etc., but can’t seem to locate a template for an approved agreement. Are boilerplate agreement templates available or should agreements be created from scratch?
Answer 1: My recommendation is to create something that addresses each physician practice. Our experience has been that boilerplates create more problems than solutions.
This question was answered by: David A. Williams, FHFMA, CPA, partner, Horne LLP, and a member of HFMA’s Mississippi Chapter.
Answer 2: This agreement has aspects of gainsharing that may be helpful.
See related tool: Management Services Performance Improvement Agreement Between Hospital and Physician Group
This question was answered by: Curtis H. Bernstein, CHFP, CPA/ABV, ASA, CVA, principal, Pinnacle Healthcare Consulting, and a member of HFMA’s Colorado Chapter.
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