Physician executives saw their pay rise between 2009 and 2011, but at the slowest pace since 1999–2001, according to a survey of members of the American College of Physician Executives (ACPE) by Cejka Executive Search. “The two-year rate of increase in total compensation — at 5.9 percent — is well below the 11.6 percent increase reported in 2009 and the lowest since the 2001 survey reported a 5 percent increase,” the survey notes.

“Margin pressure, reduced volumes, and public scrutiny in tough economic times all contribute to the impact on executive compensation.”

There are ways to mitigate this, though. Physician executives with postgraduate management degrees were able to maintain an “earning power advantage.” The survey says that if you’re a chief medical officer with a master of business administration degree or a master of medical management degree, you can earn up to 14 percent (MBA) and 16 percent (MMM) more than CMOs who do not have those degrees. Medical directors can earn up to 9 percent more with an MBA or MMM.

Health care reform may also create some opportunities. The survey says that “the need for physicians with specialized areas of expertise may be driving greater earning power for physician executives in new roles. For instance, there were notable increases for physicians responsible for information management....”

The results are based on a survey of about 2,000 ACPE members and include responses from clinician executives at health insurance plans.

2011 compensation based on postgraduate degree

Source: “2011 Physician Executive Compensation Survey,” Cejka Executive Search and the American College of Physician Executives. More information: http://snipurl.com/cejka2011

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.