Finally, some encouraging news about physician supply. Enrollment at medical schools increased by 3.1 percent this year and if that continues, total enrollment could go up by 30 percent by 2016, according to a study by the Association of American Medical Colleges.

Eleven medical schools included in the survey admitted their inaugural classes between 2007 and 2012. In 2012, 4 percent of first–year medical school students attended those schools.

Men are fueling the surge. “The number of men applying to and enrolling in medical school increased [in] all racial and ethnic groups,” according to an AAMC statement.

Applicants held strong academic credentials, with an average undergraduate GPA of 3.54 and combined median MCAT score of 29.

There are still bottlenecks. The AAMC states that the enrollment “will not [yield] a single new doctor to care for patients unless Congress lifts the 1997 limits on residency training positions.”

The students in the study have not yet chosen a specialty, which they do at the end of their fourth year, so anyone who wants to see how the primary care physician shortage might be addressed will have to wait until then for the official word.

Meanwhile, the AAMC does ask medical students what specialty they intend to follow in its “Matriculating Student Questionnaire,” and the 2012 version of this is due within the next few months.

It will be posted on the AAMC’s Web site: www.aamc.org.

Total and first-time applicants to U.S. medical schools

Change in number of total applicants from prior year

First-time enrollment

Source: Association of American Medical Colleges

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.