Hospital-physician gainsharing in cardiology.

The Health and Human Services Office of Inspector General has approved a handful of gainsharing arrangements in which physicians receive cash payments for reducing hospital spending. Gainsharing might reduce costs by aligning hospital and physician incentives, but concerns remain about quality and access. We examine the effects of thirteen gainsharing programs on coronary stent patients. Compared to other hospitals, gainsharing hospitals reduced costs by 7.4 percent per patient, with 91 percent of the savings from lower prices and 9 percent from lower utilization. The available measures of access and quality suggest that neither was reduced, nor was access to drug-eluting stents before 2006.