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Gainsharing for spinal fusion

This article was originally published in The Gray Sheet

Executive Summary

HHS Office of Inspector General posts its eleventh positive 1advisory opinion Aug. 7 for the Goodroe Healthcare Solutions model of gainsharing. Unlike the previous opinions, which addressed hospitals sharing with physicians the cost savings accrued by adopting new protocols for certain cardiac procedures, the latest opinion focuses on spinal fusion. Savings to be shared with orthopedic surgeons and neurosurgeons from the program in question resulted from implementing 36 recommendations involving standardization of fusion devices and supplies, and limiting the use of bone morphogenetic protein to an as-needed basis, reducing its use from 15% to 11% of cases. Gainsharing arrangements, which run the risk of violating the federal anti-kickback statute and civil monetary penalty, have met resistance from device manufacturers due to their focus on product standardization (2"The Gray Sheet" May 26, 2008, p. 12)
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