Modern Healthcare - - REGIONAL NEWS -

NEW YORK— The U.S. Jus­tice De­part­ment’s an­titrust di­vi­sion said it will not chal­lenge the Greater New York Hospi­tal As­so­ci­a­tion’s pro­posed pro­gram that would re­ward physi­cians at mem­ber hos­pi­tals with a share of sav­ings achieved by us­ing re­sources more ef­fi­ciently. The GNYHA submitted a busi­ness re­view re­quest in Au­gust for the vol­un­tary gain­shar­ing pro­gram, which will in­volve com­mer­cial health in­surance and Medi­care and Med­i­caid man­aged-care prod­ucts. The Jus­tice De­part­ment said in a Jan. 16 let­ter that it doesn’t in­tend to chal­lenge the pro­gram be­cause the hos­pi­tals will not ex­change con­fi­den­tial and com­pet­i­tive in­for­ma­tion. In ad­di­tion, each par­tic­i­pat­ing hospi­tal will be in­di­vid­u­ally re­spon­si­ble for set­ting physi­cian gain-shar­ing pay­ments. “Based on GNYHA’s rep­re­sen­ta­tions, the pro­posed in­for­ma­tion shar­ing pro­gram is un­likely to fa­cil­i­tate col­lu­sion or oth­er­wise raise com­pet­i­tive con­cerns,” Bill Baer, as­sis­tant at­tor­ney gen­eral for the Jus­tice De­part­ment’s an­titrust di­vi­sion, wrote in the let­ter. The pro­gram will use a third-party con­trac­tor to cal­cu­late a “best-prac­tice norm” for cer­tain in-pa­tient treat­ments or pro­ce­dures. That data will be used to mea­sure physi­cian per­for­mance. A physi­cian who meets hospi­tal-es­tab­lished qual­ity stan­dards while re­duc­ing costs could re­ceive a share of the hospi­tal’s sav­ings. Eleven of the as­so­ci­a­tion’s roughly 100 mem­ber hos­pi­tals in New York have reg­is­tered for the pro­gram, ac­cord­ing to the let­ter. A GNYHA spokesman said the pro­gram is not con­nected to GNYHA Ven­tures, the as­so­ci­a­tion’s for-profit busi­ness that in­cludes group-pur­chas­ing ser­vices. Ad­di­tional in­for­ma­tion about the pro­gram was not im­me­di­ately avail­able. —

Jaimy Lee

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