In response to concern that there will be a shortage of physicians, the Association of American Medical Colleges (AAMC) recommends a 30 percent increase in U.S. medical school enrollment by 2015. A new report from the AAMC’s Center for Workforce Studies suggests that enrollment is on track to reach that goal, but by 2018, not 2015. This recommendation uses the first year enrollment of 16,488 students in 2002 as a baseline. A 30 percent increase would lead to 21,434 first-year medical students, an increase of 4,946 students per year.

Edward Salsberg, director of the Center for Workforce Studies at the AAMC, encourages the managed care industry to consider the need for clerkship and residency training.

By increasing their involvement in the educational process, health plans can help assure that the future generation of physicians is prepared to work in those settings, says Salsberg.

“Some health plans may be able to facilitate the expansion of residency training — which can be a good recruitment tool,” Salsberg says . If a residency program is well designed, residents are more likely to stay in the facility or setting they were trained in. By giving exposure while training, more residents will be familiar with managed care organizations. “Where a physician trains has a big impact on where he practices after training,” he says.

Medical school enrollment

Of the 125 accredited medical schools surveyed, 104 have increased enrollment since 2002 or plan to increase it by 2014.

©2010 Association of American Medical Colleges. All rights reserved. Reproduced with permission.

8 new med schools expected

Edward Salsberg, director of the Center for Workforce Studies at the AAMC, says the organization surveys medical schools each year about their enrollment plans for the next five years, shown below by a solid line through 2009. “The dotted line is a projection through 2014 based on the survey, further growth based on estimates from new schools in the pipeline, and a projection from the existing schools based on historical growth,” says Salsberg.

Source: Results of the 2009 medical school enrollment survey. Center for Workforce Studies, March 2010

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.