Gainsharing Experiments in Health Care

Markham, Steven E.; Scott, K. Dow; Little, Beverly L.; Berman, Steven

doi:10.1177/088636879202400210

Cited by 2 publications

(5 citation statements)

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“…The percentages of all manufacturing workers negotiating contracts in a given year in which the contract included both profit sharing and a wage concession, were 0.0 percent through 1980, 1.4 percent in 1981, 33.2 percent in 1982, 8.4 percent in 1983,0.9 percent in 1984,1.7 percent in 1985,16.7 percent in 1986, 4.3 percent in 1987, and 0 percent in 1988. Comparison of these numbers with those reported in table 1.1 reveals that wage concessions existed for a majority of workers in profitsharing manufacturing contracts only in 1982, 1983, and 1986. 13. Additional recent survey evidence is contained in Markham, Scott, and Little (1992) and Lissy (1991).…”

Section: New Data On Profit Sharing In Publicly Held Companiesmentioning

confidence: 99%

“…It does not include studies of productivity-gainsharing plans such as Scanlon and Rucker plans (Schuster 1983(Schuster , 1984, and IMPROSHARE (Fein 1981(Fein , 1983Globerson and Parsons 1987;Kaufman 1992). For gainsharing case studies see the meta-analysis in Bullock and Tubbs (1990), as well as Robertson and Osuorah (1991), Markham et al (1992), Masternak (1991/92), Masternak and Ross (1992), Gowen (1990), andHansen andWatson (1990). This review is based on all pub lished studies that could be located in books or in economic, personnel, and business journals (using searches up through June 1993 of the Business Periodicals Index and the computerized databases ABI/INFORM, UNCOVER, ProQuest, and Business Dateline), and on unpublished studies made available by colleagues.…”

Section: Does Profit Sharing Interact With Other Personnel Policies?mentioning

confidence: 99%

“…50. For studies of gainsharing see the meta-analysis in Bullock and Tubbs (1990), as well as Schuster (1983Schuster ( 1984, Robertson and Osuorah (1991), Markham et al (1992), Masternak (19917 92), Masternak and Ross (1992), Gowen (1990), and Hanson and Watson (1990).…”

Section: Does Profit Sharing Interact With Other Personnel Policies?mentioning

confidence: 99%

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Profit Sharing: Does It Make a Difference?

Kruse¹

1993

205

151

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Section: New Data On Profit Sharing In Publicly Held Companiesmentioning

confidence: 99%

Section: Does Profit Sharing Interact With Other Personnel Policies?mentioning

confidence: 99%

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Profit Sharing: Does It Make a Difference?

Kruse¹

1993

205

151

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“…Example of papers belonging to the first stream are Romanoff and Williams (1990), Markham et al. (1992), Greenwald et al. (2016), and Althausen and Mead (2016).…”

Section: Literature Reviewmentioning

confidence: 99%

“…The first contains papers that discuss the design and implementation of gainsharing programs but make no mention of a specific formula, and the second contains papers that do. Example of papers belonging to the first stream are Romanoff and Williams (1990), Markham et al (1992), Greenwald et al (2016), and Althausen and Mead (2016). In the first two papers, gainsharing is meant for the hospital's salaried staff.…”

Section: Literature Reviewmentioning

confidence: 99%

Gainsharing Contracts for CMS’ Episode‐Based Payment Models

Gupta

Mehrotra

Tang

2021

Production and Operations Management

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The Centers for Medicare and Medicaid Services (CMS) has introduced several Episode‐based Payment Models. Episodes are combinations of pre‐acute, acute, and post‐acute services for particular medical conditions. During the year, CMS pays hospitals according to historical norms. At the end of the year, these payments are reconciled against a target price, resulting in either a gain or a loss for the hospital. The hospital may also realize gains or losses from its internal operations. It may incentivize physicians to select certain treatment levels that improve quality and reduce costs by offering to share gains and losses. CMS has placed restrictions on what gains or losses may be shared and implemented stop‐loss and stop‐gain (SLSG) provisions for the hospital and the physicians. In this study, we consider a class of affine gainsharing functions that calculate a physician’s per‐episode share based on both the aggregate performance across all physicians, and the cost and quality outcomes achieved by that physician. We show that when there are no sharing restrictions and no SLSG provisions, an optimal gainsharing function lies in the class of affine functions. In contrast, when there are SLSG constraints, the contract design problem is analytically challenging. Therefore, we perform a series of numerical experiments, which reveal that the hospital SLSG provisions, the maximum savings potential, and the hospital’s risk preferences determine the amount of gains and losses that the hospitals share and the resulting treatment levels. From the CMS perspective, we show that SLSG constraints matter more to hospitals with higher historical average billing and higher risk aversion.

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Gainsharing Experiments in Health Care

Cited by 2 publications

References 0 publications

Profit Sharing: Does It Make a Difference?

Profit Sharing: Does It Make a Difference?

Gainsharing Contracts for CMS’ Episode‐Based Payment Models

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