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Medicare Picks N.J. to Test Innovative Incentive System
Date:8/18/2009

Hospitals, Physicians Work Together to Cut Costs, Improve Quality

PRINCETON, N.J., Aug. 18 /PRNewswire-USNewswire/ -- Twelve New Jersey hospitals and their participating physicians have received approval from the federal government to test an innovative new incentive method that aims to reduce healthcare costs while improving quality of care.

The three-year trial program could serve as a basis to overhaul government payment for Medicare services nationwide.

"Rising healthcare costs are a growing burden for all of us," said NJHA President and CEO Betsy Ryan. "This is a bold test to see if we can redesign the failed system of the past and replace it with strategies that keep healthcare affordable while making it better and safer for patients. That's essential as we embark on a national effort to reform our healthcare system."

NJHA spearheaded the effort to win a waiver from the federal Centers for Medicare and Medicaid Services to test the initiative in New Jersey. Called "gainsharing," the program offers physicians financial incentives to work with hospitals in lowering costs in a variety of ways. The program also includes stringent quality controls to protect patients.

The program is designed to encourage physicians and hospitals to work together to provide the most efficient care for patients. Currently, Medicare reimburses hospitals a fixed rate for treating a Medicare patient, based on the patient's diagnosis. But physicians are paid differently, receiving individual payments for each procedure or each day spent in the hospital. Those very different payment philosophies are inconsistent, and the gainsharing project aims to bring them together.

Under gainsharing, physicians may share a portion of the savings that are realized by working with the hospital to make a patient's stay more efficient. The overall sav
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SOURCE New Jersey Hospital Association
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