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Gainsharing in health care: meeting the quality-of-care challenge.

In health care, most gainsharing arrangements have focused on aligning economic incentives between hospitals and physicians. At one time, the Office of Inspector General had declared such arrangements flatly illegal, but recent advisory opinions suggest that the OIG is taking a more lenient stance. Today, in addition to hospital-physician arrangements, payer-provider and payer-patient arrangements are viable forms of gainsharing.