Controlling costs: Opportunities for physician-hospital collaborations and ventures

STUDY DESIGN. Analysis of federal laws, regulations, and commentary relevant to gainsharing and other physician-hospital collaborations. Review of health, legal, and medical literature to identify relevant case studies, primarily from 2000 to the present. OBJECTIVE. To illustrate a number of physician-hospital collaboration and joint venture models to explore opportunities for physicians and hospital partners to enhance revenues and contain costs in the provision of health care. SUMMARY OF BACKGROUND DATA. There are numerous physician-hospital joint ventures throughout the United States and 8 approved gainsharing programs. Few comparisons of gainsharing as compared to other joint venture structures are available to hospitals and physicians. METHODS. A narrative review of health, legal, and business literature, regulations, and commentary to identify physician-hospital collaborations and ventures as well as applicable regulatory authorities. RESULTS. There are numerous joint venture and collaboration models used throughout the country for physician-hospital collaborations with varying degrees of success. Eight approved gainsharing programs have been implemented. CONCLUSIONS. Physician-hospital collaborations, gainsharing, and joint ventures are expanding throughout the country in response to reimbursement pressures and movement of care into the ambulatory setting. These partnerships can be successful where there is sufficient alignment of interests to offset the operational and regulatory complexities that such partnerships present.