Although physician income scarcely budged from 2007 to 2008, chief medical officers (CMOs) in managed care organizations saw a marginal increase from 2008 to 2009, according to the most recent Physician Executive Management Center’s report, The 2008–09 Survey of Chief Medical Officers.

For 2008, the average salary was $270,262 and the total compensation was $334,171, which included an average bonus of 31 percent.

For 2009, 56 percent of the respondents said that they received an increase in their salary; the remainder did not. Overall, the average salary in 2009 was $274,685.

The report notes that “compensation had increased significantly in previous surveys, but has now stalled in 2008 and 2009, and potentially in 2010.”

“Compensation levels for managed care chief medical officers do seem to be affected by something, perhaps the economic conditions and uncertainty about the future, or health care reform,” says David R. Kirschman, president of the Physician Executive Management Center.

“Participants in this survey did report that they expected less in the way of increased salary levels in 2009 and 2010. The actual effect will be seen in the level of incentive payments received for 2009 and especially for 2010, which will reflect the success of their companies,” says Kirschman.

In line with these survey findings is a recent report by Medical Economics that physicians in private practice had median earnings that were roughly the same in 2008 as they were in 2007.

Pediatricians averaged $187,500, followed by family physicians, general practitioners, and internists, who averaged $162,500. Obstetrician/gynecologists had the top earnings, with a median income of $237,500.-

Total compensation and mean salary

*Mean salary has only been followed since 2000. For 2002–2003, no salary data collected.

Source: Physician Executive Management Center. The 2008–09 Survey of Chief Medical Officers. The report is available at http://www.physicianexecutive.com/.

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.