The trend of forming accountable care organizations and seeking pay-for-performance arrangements with physicians has spread throughout the country. “This is not just a one-time deal, this is a trend that’s here to stay,” Ms. Johnson said.
Ms. Johnson offered the following tips for hospitals or health systems developing pay-for-performance payment formulas or arrangements:
• Compare. Existing contracts held by government or private payors are good market comparables, according to Ms. Johnson, to make sure the contract is at fair market value.
• Follow the logic test. “It all comes down to logic,” Ms. Johnson said. For instance, in a shared savings arrangement, there needs to be a logical method for how the money is split between groups.
• Use legal counsel. If there was one takeaway from the presentation, this is it. “Loop counsel in early,” she said, and the deal is more likely to be compliant and successful.
