Notice: This CMS-approved document has been submitted - Philips ...

CMS-1403-FC
To better understand and address the variety of
incentive payment and shared savings programs that exist in
the industry or that parties would like to implement, we
are interested in detailed descriptions of incentive
payment programs and shared savings programs that include
specific descriptions of the structure and operations of
the programs and payments. We are also interested in views
addressing the likely evolution of these programs.
b. Background: Incentive Payment and Shared Savings
Programs
As we discussed in both the CY 2009 PFS proposed rule,
and the FY 2009 IPPS proposed rule, the term “gainsharing”
is commonly used to describe certain programs that seek to
align physician behavior with the goals of a hospital by
rewarding physicians for reaching predetermined performance
outcomes. Several types of programs exist (including, but
not limited to, gainsharing) for the purpose of achieving
quality standards, generating cost savings, and reducing
waste. We refer to these programs as “incentive payment”
and “shared savings” programs. Within the category of
“incentive payment” programs, we include P4P, also known as
quality-based purchasing, and other quality-focused
programs that do not involve the sharing of cost savings
from the reduction of waste or changes in administrative or
390