More and more, physicians are balancing professional time with personal time through the use of part-time employment. A survey conducted by Cejka Search and the American Medical Group Association (AMGA) shows a rise in the number of physicians who practice part time. From 2005 to 2007, the percentage of all physicians practicing part time increased from 13 percent (5 percent men and 8 percent women) to 19 percent (7 percent men and 12 percent women) — a jump of 46 percent.

“Twenty years ago, the concept of practicing medicine on a part-time basis was never heard of,” says David Cornett, regional vice president for client services at Cejka Search. The need is not coming from the organizations but from the younger physician population and those nearing retirement,” says Cornett.

Forecasts of a shortage of primary care physicians and the trend toward more part-time practice suggest that it will be increasingly difficult for health plans to ensure access to primary care providers for their members.

Cornett says that physicians want to avoid the administrative burdens of running a traditional independent medical practice and that managed care organizations can play a role by reducing those burdens.

“If managed care organizations can remove obstacles for physicians, they will be more productive — and accessible to health plan members — within the clinical hours they will be working,” says Cornett.

The survey instrument was sent to 300 AMGA member medical groups. Fifteen percent responded.

Source: Cejka Search and AMGA. 2007 Physician Retention Study.

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.