New downloadable Orthopedic Report: Gainsharing 2006 - How it Works, and What You Can Do to Prepare
BY EDITOR, DECEMBER 16, 2005
February 2010 update: This report is no longer available for purchase. Learn more here.
Is the new gainsharing a lion - or a paper tiger? Device manufacturers and surgeons alike ought to get acquainted with the facts behind gainsharing.
The conventional wisdom says surgeons are sure to win and device firms sure to lose. Not likely, we think. Our view is that disposable products (like cell savers) will be the low-hanging fruit that fuel early gainsharing wins. High-price implants, however, will be protected from the gainsharing threat by physician preference, retraining, and the sales rep-surgeon relationship.
All this assumes that the regulatory and legislative environment remains favorable to gainsharing. National elections have a way of changing Congress' priorities. And then there is the small fact that gainsharing remains technically illegal.
You will doubtless find yourself in a management-level conversation about the topic in 2006. Our report is designed to equip you for that moment.
It gives you the essential background on the topic, OIG's most important guidelines for approveable programs, five key arguments against gainsharing, and advice for device firms. See the table of contents below.
Buy Gainsharing 2006 here, for $179.
Gainsharing 2006:
How it Works, and What You Can Do to Prepare
Published December 2005
148 Pages total. (16 pages of our own analysis, followed by key publicly available documents.)
Table of Contents
Introduction
The Governing Laws of Gainsharing
Gainsharing Resurrected
- The 1999 Special Advisory Bulletin
- The 2001 and 2005 Advisory Opinions
- What Exactly Did The Hospitals Propose?
Characteristics of Approved Gainsharing Programs
- Program monitoring and transparency
- Specific cost measures
- Creation of baseline values from base year data and resulting caps on gains
- Physicians' reward is split per capita
- No Change in Products Stocked
- One Year Programs
- No Changes in Physician Group
- Summarizing the Required Safeguards
How Gainsharing Can Impact Orthopedics
- The Provider Perspective on Mix Shift
- The Manufacturer Perspective
Implications
- Considerations for Physicians
- Considerations for Medical Device Firms
HealthpointCapital's Takeaway
Appendices
- The 1999 Special Advisory Bulletin
- OIG Advisory Opinion 01-1
- OIG Advisory Opinion 05-1
- OIG Advisory Opinion 05-2
- OIG Advisory Opinion 05-3
- OIG Advisory Opinion 05-4
- OIG Advisory Opinion 05-5
- OIG Advisory Opinion 05-6
- OIG Chief Counsel Gainsharing Testimony, 7 Oct 2005
- MDMA Gainsharing Testimony, 7 Oct 2005
- Advamed Gainsharing Testimony, 7 Oct 2005
- MDMA Position Paper
- Advamed Position Paper
