Primary care physicians experienced a 2.8 percent median increase in compensation last year, and specialists in general reported a 4.3 percent median increase, although some notable medical specialties experienced decreases in compensation. Results are compiled in the Medical Group Management Association's Physician Compensation and Production Survey: 2003 Report Based on 2002 Data.

Invasive and noninvasive cardiologists reported lower incomes in 2002, for the first time in several years. Their compensation declined 6.2 percent and 3.9 percent, respectively, from 2001 to 2002. Other specialties that experienced a decline from 2001 to 2002 include general surgeons (0.8 percent), pulmonologists (2.6 percent), and urologists (3.0 percent).

These compensation numbers differ from our report last month, "Primary Care Pay Falls Again," however. In last month's column, the American Medical Group Association's 2003 Medical Group Compensation and Productivity Survey showed internists receiving less compensation, to the tune of a 1.8 percent decrease, while urologists experienced a 7.9 percent increase from 2001 to 2002. The disparity between the two surveys is also apparent for noninvasive and invasive cardiologists — the trend depicted in last month's column was a lot rosier.

"Differences in sample sizes, different types of groups responding to the surveys could lead to this disparity," says Liz Johnson, a spokeswoman for the MGMA. She also points out that the MGMA survey did not include academic physician groups. "Typically, physicians in academic settings make less than their private sector counterparts and that could bring down the salary medians."


Managed Care’s Top Ten Articles of 2016

There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

They bring a different mindset. They’re willing to work in teams and focus on the sort of evidence-based medicine that can guide health care’s transformation into a system based on value. One question: How well will this new generation of data-driven MDs deal with patients?

The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

A flood of tests have insurers ramping up prior authorization and utilization review. Information overload is a problem. As doctors struggle to keep up, health plans need to get ahead of the development of the technology in order to successfully manage genetic testing appropriately.

Having the data is one thing. Knowing how to use it is another. Applying its computational power to the data, a company called RowdMap puts providers into high-, medium-, and low-value buckets compared with peers in their markets, using specific benchmarks to show why outliers differ from the norm.
Competition among manufacturers, industry consolidation, and capitalization on me-too drugs are cranking up generic and branded drug prices. This increase has compelled PBMs, health plan sponsors, and retail pharmacies to find novel ways to turn a profit, often at the expense of the consumer.
The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.

Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.