The OIG has approved the first orthopedic and spine gainsharing project, which will be overseen by Goodroe Healthcare Solutions, LLC. This will be Goodroe's eleventh OIG program; previous programs have been focused on the cardiovascular sector. No details have been... more
Hoping to "align financial incentives" between hospitals and physicians, CMS announced plans for an Acute Care Episode (ACE) demonstration that will feature bundled payments for the treatment of certain orthopedic and cardiac patients. CMS argues that bundling, compared to paying... more
In a 2006 survey of 95 orthopedists, published in JBJS in September, 61% of respondents said they believed that gainsharing programs ("arrangements in which hospitals and physicians share in any cost savings achieved through greater efficiencies and physicians' effort") were... more
Last week's Medical Device Manufacturers Association Annual Meeting in Washington, D.C. gave us an opportunity to applaud the passion and dedication that defined MDMA's past accomplishments and will carry future negotiations on regulatory, reimbusement and marketplace issues for smaller device... more
This afternoon MDMA held its monthly call, outlining policy changed that are on the horizon for 2007. We've outlined some of their comments below: MDUFMA Negotations for MDUFMA II have been ongoing since February of 2006. The FDA has recently... more
Earlier this month, the Office of the Inspector General (OIG) issued a new opinion over gainsharing. The cardiologist group who submitted the request received a favorable response, with the OIG determining that though the arrangement may violate the Social Seucrity... more
This week CMS proposed a 5.1% reduction in payments to physicians for 2007. The proposal will impact the 875,000 doctors who care for the elderly and disabled in the US. The explanation for the cut is that spending on physician... more
On June 14th and 15th, we attended the Medical Device Manufacturers Association (MDMA) Annual Meeting. The organization provides medical device entrepreneurs an opportunity to have their voices heard on the hill. Innovation in our industry generally comes from the smaller... more
The Hill, "The Newspaper for and about the U.S. Congress", posted on its website last week a list of 14 top medical device industry lobbyists. Leading this list is Stephen Ubl, who is seen as "a triple-A superweight." Newly appointed... more
Our regular readers will remember that a few months ago, Zimmer and HCA had an unusually public fight. To briefly review, HCA entered into volume discount contracts with Zimmer, Stryker and DePuy. At year end, the implant companies reported HCA... more
One of the most informative sessions at AAOS was a section of the Health Policy Update Symposium delivered by William L. Healy, M.D. of the Lahey Clinic. Healy gave real-life examples of the complicated and delicate balance of hospital economics,... more
There has been a lot of focus over the past six months on pricing in the orthopedic device market. Two topics generating fear have been (1) HCA's purchasing practices and (2) gainsharing. This week, Melissa Davis of The Street.com wrote... more
A number of people have asked us what we wrote in our Gainsharing report. So we decided to share some of it. The impact of gainsharing on orthopedic companies will be driven in significant part by the savings that hospitals... more
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.... more
Due to last week's Merrill Lynch investor conference (subscription may be required), investors have regained confidence in the orthopedic sector after the industry faced some hurdles within the past few months. In our HealthpointCapital Weekly Valuation Index, P/E (price-to-earnings) jumped... more
The latest issue of Health Affairs contains a troubling study for the surgeon-owned hospital industry. Jean Mitchell, a professor of public policy at Georgetown University, took an in-depth, quantitative look at heart doctors and hospitals in Arizona. In particular, she... more
By Joane H. Goodroe President and CEO Goodroe Healthcare Solutions, LLC [Editor's note: We welcome consultant Joane H. Goodroe as a guest blogger. See her profile here.] On Friday, October 7th, the House Ways and Means Subcommittee on Health held... more
Is Wall Street's shrill reaction to hip and knee implant pricing concerns overblown? Even with sophisticated econometric tools such a question is difficult to evaluate because we are dealing with an expectations driven phenomenon. So we have our doubts about... more
This morning, the Congressional Subcommittee on Health with be conducting a hearing on gainsharing. Speaking at the hearing as a witness, will be one our guest bloggers, Joane Goodroe. In preparation for the hearing, AdvaMed (an industry group) funded a... more
Yesterday we attended a panel discussion at Mintz Levin called "Show Me the Revenue: Joint Ventures and Alliances Among Hospitals, Physicians and Investor-Owned Companies". Although gainsharing is the latest method for physicians to improve their incomes and possibly lower healthcare... more
[Update: We're moving this entry to the top of the blog due to an interesting dialogue between our readers and the author, Joane Goodroe... a "must read"!] more
There is no denying that healthcare costs continue to accelerate in the U.S. We would argue most of these costs are justified given the continuing technological advancements made within the entire healthcare arena including medical devices and biotechnology. However, we... more
This is our final report regarding the Orthopedic Intelligence Conference conducted by Sg2. We wanted to highlight what we considered to be the most significant aspect of the conference -- gainsharing -- a hot topic that has received significant attention... more
Greetings from the SG Cowen and ISI Health Care Policy Conference in Washington D.C. It's been a full day covering Medicare, Medicaid, FDA, Specialty Hospital Policy and Gainsharing. We've heard from Representative Pete Stark (D-CA) and Senator Debbie Stabenow (D-MI),... more
Greetings from the SG Cowen and ISI Health Care Policy Conference in Washington D.C. It's been a full day covering Medicare, Medicaid, FDA, Specialty Hospital Policy and Gainsharing. We've heard from Representative Pete Stark (D-CA) and Senator Debbie Stabenow (D-MI),... more
Last week I listened in on an audio conference regarding the DOJ investigations. Certain comments by Jim Sheehan, AUSA for the Eastern District of Pennsylvania were quite interesting and provide some guidance... more
We think reimbursement and regulatory issues are critical in orthopedics. On June 30th, John McCormick and I will be attending the SG Cowen and ISI Health Care Policy conference in Washington D.C. It looks like a great set of speakers... more
Background on Gain Sharing. The Hospital Corporation of America ("HCA") has recently asked the Office of Inspector General ("OIG") of the Department of Health & Human Services ("HHS") to allow for "gain-sharing" arrangements. These gain-sharing arrangements would allow hospitals to... more
Complete Archive
