A coalition of medical imaging organizations and patients' advocacy groups asked the Medicare Payment Advisory Commission this week to reconsider its call for reduced reimbursements and required prior authorization for imaging services.
In a letter to MedPAC Chairman Glenn Hackbarth, the Access to Medical Imaging Coalition said the commission's recommendations "would further limit access to life-saving diagnostic imaging services while yielding questionable savings for the Medicare program."
The coalition, which includes dozens of medical imaging groups and professional medical associations, including the American College of Radiology, told Hackbarth it was particularly concerned about MedPAC's call for prior authorization for imaging services.
"Prior authorization has never been used in the Medicare program, impedes patient access to needed care, places huge administrative burdens on providers, and has not been shown to reduce costs over the long term," AMIC said in the letter.
"From the perspective of patient advocates prior authorization would mean placing a barrier between patients and services their physician believes are necessary, which could lead to delayed or denied care. From the provider perspective, prior authorization means having to devote additional uncompensated physician time as well as staff to a burdensome administrative process," AMIC said in the letter.
Nine patients' advocacy groups cosigned the letter with AMIC, including It's My Heart, Colon Cancer Alliance, and Kidney Cancer Association.
Tim Trysla, executive director of AMIC, said in a media release that patients affected by cancers, heart disease, and other illnesses need to be made aware of the potential impact of the MedPAC recommendations.
"Even though MedPAC has acknowledged that the most recent Medicare claims data show that advanced imaging spending and volume are flat, they are recommending further cuts to imaging reimbursement and an unprecedented prior authorization program that would, by definition, impede beneficiaries' access to care," Trysla said. Trysla said there is no scientific research validating the clinical quality of radiology benefit managers or whether they truly achieve cost savings or merely shift costs. He said there are numerous peer-reviewed articles supporting the use of advanced imaging studies. "RBMs are not accountable or transparent to the public, and their proprietary algorithms deny or delay care without any peer-reviewed clinical evidence showing they are safe," he said.
Compensation growth for primary care and specialty care physicians was all over the board in 2010, and appeared to be determined as much by location as by area of medical expertise, according to a survey from the Medical Group Management Association.
"A number of factors may attribute to regional differences in physician compensation," Jeffrey B. Milburn, with MGMA Health Care Consulting Group, said in a media release. "The supply and demand for primary care or specialty physicians may influence compensation. A high level of competition between groups or specific specialties may provide an opportunity for payers to reduce reimbursement. In states where payers have little competition, reimbursement and subsequent physician compensation may be lower."
The survey -- Physician Compensation and Production Survey: 2011 Report Based on 2010 Data -- found that median compensation for both primary care physicians and specialists was highest in southern states, with primary care physicians earning a median of $216,170, and specialists earning a median $404,000. By comparison, primary care physicians in eastern states earned a median $194,409, and specialists earned a median $305,575.
"Location desirability is another factor influencing competition and compensation," Milburn said. "Some areas have a much higher ratio of physicians to population, and one might think this would lead to increased competition and lower compensation. But, the usual laws of supply and demand aren't always at work in healthcare."
The survey results are consistent with those in a report last week from physician recruiters Merritt Hawkins, which showed that most job openings for physicians are in hospitals, while demand for private practice physicians is on the wane.
Among primary care physicians: internists reported median compensation of $205,379 in 2010, an increase of 4.2% since 2009; family practitioners reported a median of $189,402, an increase of 2.9%; and pediatricians reported their median compensation was $192,148, an increase of .39%. Since 2006, median compensation has risen 15.5% for family practitioners, 13.3% for internists; and 10.3% for pediatricians, the survey found,
There was even greater variance for specialists. Orthopedic surgeons reported median compensation of $514,659 -- the highest median of any specialty in the survey -- up 3.7% from 2009, and 15.2% from 2006. However, urologists reported median compensation of $372,455, a drop of 4.66% from 2009, and up 4.15% from 2006, while radiology/diagnostic reported median compensation of $471,253, a drop of 1.6% compared to 2009, and up 5.5% from 2006.
The survey provides data on nearly 60,000 providers, which MGMA said is the largest and most representative provider population of any physician compensation survey in the United States.
Three major healthcare organizations in Kentucky announced plans Tuesday to form a statewide healthcare system.
The system will include the University of Louisville Hospital/James Graham Brown Cancer Center; Jewish Hospital & St. Mary's HealthCare based in Louisville, and Saint Joseph Health System based in Lexington.
The Centers for Disease Control and Prevention and the American Heart Association rank Kentucky among the 10 states with the worst health indicators in the nation for cancer, obesity and death due to heart disease and stroke. More than half of the state is designated as medically underserved and there is a growing scarcity of physicians across Kentucky.
ROUNDS: The Real Value of ACOs When: August 16, 12:00–3:00 pm ET Where: hosted by Norton Healthcare Register today for this live event and webcast
"There is so much more we can accomplish together. Most important, we will be increasing access to basic and advanced health services," Bob Hewett, who will be the first chair of the system's community board of trustees, said in a media release. "That will lead to improving the health not only of individual patients, but of entire communities. At the same time, we will work to lower costs as we advocate for the poor and underserved in our communities."
The sponsors are Jewish Hospital HealthCare Services, University of Louisville, Denver-based Catholic Health Initiatives, and its affiliate Saint Joseph Health System. Jewish Hospital & St. Mary's HealthCare formed in 2005 in a joint venture of Jewish Hospital HealthCare Services and CHI.
The network will include hospitals, clinics, specialty institutions, home health agencies, satellite primary care centers and physician groups with 91 locations combined.
Under the partnership, CHI will make an incremental capital infusion of $320 million to support the system's mission and healthcare services statewide. And the system will invest $200 million to expand the academic medical center in Louisville and $100 million in statewide healthcare services.
The partnership will result in a system with a medical staff of more than 3,000 academic and community physicians across Kentucky. Technology – especially telemedicine – will enable network physicians to expand access to specialty care that many communities have not had available before. The proposed system will combine the faith-based and academic missions of the partner organizations, integrating medical research, education, technology and healthcare services wherever patients receive care. The network will collaborate with all healthcare providers, enhancing existing relationships and developing new partnerships, according to the media release.
ROUNDS: The Real Value of ACOs When: August 16, 12:00–3:00 pm ET Where: hosted by Norton Healthcare Register today for this live event and webcast
Plans call for expanding the academic medical center in Louisville to include the University of Louisville Hospital, James Graham Brown Cancer Center, Jewish Hospital and Frazier Rehab Institute, and extending research and teaching programs of the University of Louisville statewide through an academic affiliation agreement with the University of Louisville School of Medicine.
The partnership still must receive regulatory approvals before becoming effective, which could take up to a year. Until then, the partners will operate as separate organizations, the three systems said in a joint media release.
The National Quality Forum board has announced that it has approved for endorsement a list of 29 serious reportable events in healthcare. The list includes four new events, along with 25 updated events from an earlier endorsement in 2006.
The four new serious reportable events are:
Radiologic events that cause the death or serious injury of a patient or staff associated with the introduction of a metallic object into the MRI area;
Death or serious injury of a neonate associated with labor or delivery in a low-risk pregnancy;
Patient death or serious injury resulting from the irretrievable loss of an irreplaceable biological specimen, and;
Patient death or serious injury resulting from failure to follow up or communicate laboratory, pathology, or radiology test results.
“Tens of thousands of lives are forever changed each year as a result of healthcare errors,” said Janet Corrigan, president/CEO of the National Quality Forum said in a media release. “This newly expanded list of serious reportable events across multiple settings provides a critical opportunity to learn from mistakes and take swift action to improve patient safety.”
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The first NQF-endorsed list of Serious Reportable Events in Healthcare was released in 2002 as a set of events that might form the basis for a national state-based reporting system. This uniform approach to measurement helps to drive overall national improvement in patient safety. Currently, more than half of states use the NQF-endorsed list of SREs in their public reporting programs.
For the current endorsement project, each of the SREs has been reviewed for its applicability to four specific settings of care: hospitals, outpatient or office-based surgery centers, skilled nursing facilities, and ambulatory practice settings, specifically office-based practices. The report focuses on identifying and specifying each event for public reporting within the applicable settings of care.
The 2011 update is designed to: 1) ensure the continued currency and appropriateness of each event in the list; 2) ensure the events remain appropriate for public accountability; and 3) provide guidance gained by implementers to those just beginning to report these events, across hospitals and for three newly specified settings of care—office-based practices, ambulatory surgery centers, and skilled nursing facilities, NQF said.
The updated serious reportable events include:
1. Surgical or invasive procedure events:
Surgery or other invasive procedure performed on the wrong site
Surgery or other invasive procedure performed on the wrong patient
Wrong surgical or other invasive procedure performed on a patient
Unintended retention of a foreign object in a patient after surgery or other invasive procedure
Intraoperative or immediately postoperative/postprocedure death in an ASA Class 1 patient
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2. Product or device events
Patient death or serious injury associated with the use of contaminated drugs, devices, or biologics provided by the healthcare setting
Patient death or serious injury associated with the use or function of a device in patient care, in which the device is used or functions other than as intended
Patient death or serious injury associated with intravascular air embolism that occurs while being cared for in a healthcare setting
3. Patient protection events
Discharge or release of a patient/resident of any age, who is unable to make decisions, to other than an authorized person
Patient death or serious injury associated with patient elopement (disappearance)
Patient suicide, attempted suicide, or self-harm that results in serious injury, while being cared for in a healthcare setting
4. Care management events
Patient death or serious injury associated with a medication error (e.g., errors involving the wrong drug, wrong dose, wrong patient, wrong time, wrong rate, wrong preparation, or wrong route of administration)
Patient death or serious injury associated with unsafe administration of blood products
Maternal death or serious injury associated with labor or delivery in a low-risk pregnancy while being cared for in a healthcare setting
(NEW) Death or serious injury of a neonate associated with labor or delivery in a low-risk pregnancy
Patient death or serious injury associated with a fall while being cared for in a healthcare setting
Any Stage 3, Stage 4, and unstageable pressure ulcers acquired after admission/presentation to a healthcare setting
Artificial insemination with the wrong donor sperm or wrong egg
(NEW) Patient death or serious injury resulting from the irretrievable loss of an irreplaceable biological specimen
(NEW) Patient death or serious injury resulting from failure to follow up or communicate laboratory, pathology, or radiology test results
5. Environmental events
Patient or staff death or serious injury associated with an electric shock in the course of a patient care process in a healthcare setting
Any incident in which systems designated for oxygen or other gas to be delivered to a patient contains no gas, the wrong gas, or is contaminated by toxic substances
Patient or staff death or serious injury associated with a burn incurred from any source in the course of a patient care process in a healthcare setting
Patient death or serious injury associated with the use of physical restraints or bedrails while being cared for in a healthcare setting
6. Radiologic events
A. (NEW) Death or serious injury of a patient or staff associated with the introduction of a metallic object into the MRI area
7. Potential criminal events
Any instance of care ordered by or provided by someone impersonating a physician, nurse, pharmacist, or other licensed healthcare provider
Abduction of a patient/resident of any age
Sexual abuse/assault on a patient or staff member within or on the grounds of a healthcare setting
Death or serious injury of a patient or staff member resulting from a physical assault (i.e., battery) that occurs within or on the grounds of a healthcare setting
The nation's nonprofit hospitals collected $8.26 billion in philanthropic donations in fiscal year 2010, not as high as pre-recession levels, but trending strongly in the right direction, according to a report from the Association for Healthcare Philanthropy.
AHP President/CEO William C. McGinly told HealthLeaders Media the 8% increase in donations in 2010 doesn't make up for the declines that hospitals endured in fiscal 2009. Still, he was surprised and encouraged by the report's findings. "In 2009 we dropped 11%, which was nearly $1 billion," he said. "I was hoping we would recover half of that loss this year in 2010, and we are ahead of that. So it's a little better than we thought. We are excited about that. This gives us a sense that we are slowly moving back in the right direction."
The AHP's annual survey showed that donations and grants to healthcare institutions in the not-for-profit sector totaled $8.2 billion in fiscal 2010, up $620 million over the $7.6 billion raised in fiscal year 2009. While last year's total was still short of the $8.6 billion raised in FY 2008 and the FY 2007 level of $8.3 billion, the 8% growth was the healthiest rate of advance since FY 2006.
A further breakdown in the report shows that individual donors contributed almost 60% of total giving. "We are seeing what I call 'the family' stay steady," McGinly says. "Over half the donations are coming from the employees, the boards, and foundations of the hospitals, the physicians, and grateful patients. That family group is still holding strong through all of this. They are the people in the know. They know better what the hospital is providing than the public they are serving in their community."
Annual giving was the largest fundraising source in fiscal 2010 and accounted for 20% of all funds raised, followed by major gifts (17%), capital campaigns (15%) and special events (15%). Planned giving, such as bequests, charitable gift annuities, charitable remainder trusts, and similar long-term philanthropic arrangements, accounted for 9.5 % of donations last year, similar to pre-recession levels.
In fiscal 2010, as in previous years, healthcare organizations used most of their donated dollars – 22% -- to fund construction and renovation, down from 27% in fiscal 2009. New and upgraded equipment purchases were the second-largest category, at 21%, followed by general operations at 18% -- both up slightly from FY 2009.
McGinly says hospitals are using more donations to pay for operational costs, especially with anticipated reimbursement reductions from Medicare and Medicaid. "Somehow hospitals are going to have to make that up and that is where more and more of the philanthropic dollars will be going," he said. "Ten years ago, 7% or 8% of philanthropy was going towards operations. That need is growing as hospitals struggle with the bottom line because of the cuts to reimbursements."
While philanthropy still provides a good return on investment, McGinly says the cost of raising money continues to go up. At 33 cents in fiscal 2010, the cost-to-raise-a-dollar through philanthropy remained stubbornly above 30 cents for the third year in a row. Return-on-investment declined, on average, more than 4% to just $3.05 raised for every dollar spent on fundraising.
The bottom line: Fundraising has become more challenging and, therefore, more expensive. Additional resources are needed to raise the same amount of funds during difficult economic times, the report said.
Higher than average success raising money donations was seen by fundraising programs that help to sustain hospitals associated with academic institutions and children's hospitals, by programs that have been in existence for 15 or more years, and by programs with at least four professional fundraisers on staff. McGinly says healthcare organizations with strong philanthropic arms will be best positioned to collect donations if the economic recovery – however uneven – continues.
"We are going to see a big upswing in this coming year unless something goes wrong with the economy," McGinly says. "The economy is improving and what we are finding is of our high performing group, those who didn't have to lose staff or make cutbacks, they weathered the storms through parts of 09 and 10 and you are going to see those major donors coming back in a big way."
Ultimately, healthcare donations are tied to the economy, McGinly says. "The economy undergirds an awful lot of what donors are feeling and how generous they feel they can be," he says. "If they don't feel as wealthy as they used to because of the economy, while they are still going to be connected, they may not be as generous.
A copy of the AHP Report on Giving Fact Sheet is available here.
Sometimes, covering healthcare as a journalist seems more like covering the police blotter.
Let's be clear that medicine is a noble profession, practiced by highly trained professionals, the vast majority of whom are dedicated to their healing mission. Nonetheless, in the last few weeks, there has been a rash of high-profile incidents -- some of them criminal -- that shine a light on an unsavory corner of the healthcare sector.
So, what's going on here? Is healthcare in the midst of a crime wave, or some other sort of moral failings? I don't believe so. It is fair to say, however, that healthcare professionals should never – if they ever did – consider their industry immune, exempt, or protected from the problems of the larger society.
In fact, one could argue that no other industry more accurately reflects the population it serves, warts and all.
First, a lot of people work in healthcare. The industry employs more than 14 million people who work in all sorts of jobs, from environmental services to the c-suite, in just about every town in the United States. There are going to be some bad eggs in there.
Second, there's the money. Total healthcare spending is closing in on $3 trillion annually, or more than $8,000 per person, and accounts for 18% of Gross Domestic Product, according to federal estimates. With all that money floating around, it's inevitable that some would be stolen or misappropriated.
Since 2009, for one small example, the U.S. Department of Justice has recovered $5.7 billion in fraud cases affecting federal healthcare programs. Obviously, that just reflects the people who got caught. The bottom line is nobody really knows how much money is misappropriated or stolen each year in the healthcare sector.
Third, there is the emotional component. Healthcare is literally the stuff of life-and-death drama. That's why it's always made for popular TV dramas. The emotions run hot because the stakes are so high. The 307 million or so Americans from all walks of life will need healthcare at some point in their lives, and it is an anxious and sometimes terrifying proposition for many of them and their families.
Fourth, as noted above, the healthcare industry serves everyone. Most hospitals are 24/7/365 operations, with open access. Just walk in the door. No metal detectors. No pat downs.
Fifth: the drugs, lots and lots of powerful, addictive, prescription drugs. Certainly healthcare workers aren't immune to the ravages of drug addiction that plague every other area of our society. And, like Willy Sutton robbing banks "because that's where the money is," drug addicts -- be they healthcare workers, patients, or thieves walking in off the street -- target healthcare organizations because that's where the drugs are.*
When these and other societal components are factored in, perhaps the question we should be asking is why isn't there more healthcare-related crime? Although I have no proof, I suspect that healthcare-related crime actually is underreported. That's only because crime is underreported everywhere else in society, and I see no reason why healthcare would be exempt from this underage. After all, it's not exempt from any other societal problem.
None of this should detract from the tremendous work that most healthcare professionals do each day in our country. It simply shows that – for better and for worse – the healthcare industry is a reflection of the people it serves.
*On a related note, let me offer this prediction and warning: The ongoing crackdown on prescription pain killer abuse at so-called "pill mills" in Florida is welcomed, and long overdue. However, although the crackdown will sever an illicit supply of prescription painkillers for tens of thousands of addicts, many of those addicts will undoubtedly search for new sources for their drug supply. To again use the wisdom of Willie Sutton, they'll go where the drugs are. Healthcare organizations, doctors offices, hospitals, and especially pharmacies, should prepare for the possibility that they will be targeted by these addicts.
Primary care physicians' associations in Florida have filed a federal lawsuit to strike down a new "physician gun gag" law that they say hinders them from talking about firearms hazards with patients.
"This is not about guns. It has nothing to do with the Second Amendment right to bear arms but it infringes upon the First Amendment right to discuss firearms safety," Lisa A. Cosgrove, MD, president of the Florida Pediatric Society/Florida Chapter of the American Academy of Pediatrics, told HealthLeaders Media.
"The bottom line is it is interfering with our right to talk to our patients. Inside of my exam room, that is private territory. It is already protected under HIPAA laws. There should be nothing that interferes with that and this does."
The legislation, HB 155 – was signed into law this month by Florida Gov. Rick Scott. Lane Wright, Scott's press secretary, defended the bill. "I think that last part is what some people miss—'if the information is not relevant to the patient's medical care or safety, or the safety of others,'" Wright said in an email to HealthLeaders Media. "The law ensures respect for a patient's right to own or possess a firearm and protects them from potential discrimination and harassment in cases where it is not relevant to the patient's medical care or safety, or the safety of anyone else in the home."
Marion Hammer, the National Rifle Association representative in Florida, said she felt compelled to bring the bill to the Florida Legislature after hearing complaints for several years that gun owners were being harassed by their physicians about their firearms.
"So, we sought sponsors for legislation that would prevent doctors from invading the privacy rights of their patients and bringing their gun ban politics into examining rooms," Hammer said. "People take their children to pediatricians for medical care, not to be lectured to get rid of their guns, not to be asked if they own guns, how many, where they are stored. Those are questions that no doctor has a right to ask unless he or she fears the patient may be a danger to him or herself or others, or unless they feel someone in the home may be a danger to the patient or others."
The Centers for Disease Control and Prevention reports that there were 31,224 firearms-related fatalities in the United States in 2007. That includes 2,251 firearms-related deaths of children ages 18 and younger – more than six youth fatalities each day. CDC estimates that there were 69,863 firearms-related injuries, including 12,371 firearms-related injuries of children ages 18 or younger in 2007.
The Florida Medical Association dropped its opposition to the bill when the NRA agreed to remove penalties that included up to five years in prison and up to a $5 million fine. Now a physician accused of violating the law will be required to go before a physician review board, and could face loss of license if they're found guilty, Cosgrove says.
Even with the weaker penalties, Cosgrove says the law goes against the practice of preventive care. "Physicians play a key role in counseling patients regarding the risk of accidental or intentional injury," she says. "It is a major health hazard facing adults and children. It is best practice to minimize those risks. As part of preventive care, doctors routinely ask about potential risks such as 'does your pool have a fence around it? Do you put up your chemicals away from your kids? Is your child buckled in a seat belt?' This is just another part of the preventive care we do."
Hammer rejects suggestions that the law chills free speech, or interferes with the patient-physician relationship."They can consult with their patients on medical care and issues that directly affect the medical care and the health and safety of the patients," she says. "They don't get to ask anything and everything they want to ask. They have no business asking a patient how much money they have in their checking account. They have no business asking if they have expensive jewelry or what cars they drive. Your personal private property is nobody else's business. If they want to ask about seat belts they certainly can. Seat belts are not protected by the constitution."
Hammer says Florida pediatricians are following an anti-gun agenda laid down by the American Academy of Pediatrics, and pushed by groups like the Brady Center to Prevent Gun Violence, which is assisting the plaintiffs in the suit.
"The American Academy of Pediatrics had on their web site for years that they support banning guns and they encouraged pediatricians to ask families if they own guns, and if they do to tell them to get rid of their guns, and if they don't to tell them not to buy guns," Hammer says. "That is not medicine and that is not appropriate and that is what the law is designed to stop."
If physicians are concerned about public safety issues, Hammer says, they should concentrate on the preventable medical errors that The Institute of Medicine has estimated kill more than 100,000 people each year. "If they want to save lives they need to clean up their own act before they go after gun owners," Hammer says.
Cosgrove says there is no way to make the law palatable for primary care physicians. "From our standpoint as the pediatric society, we said there doesn't need to be a law or anything that regulates the physician-patient relationship and nothing that interferes with what we say to our patients."
"To have a law that gags us, you start with guns, and where do you end up," she says. "Next time do you tell me I can't talk to my patients about their sexual activity, or their drug use. Where does it stop?"
A radiology clinic in West Palm Beach, FL and its former owners will pay the federal government $3 million to resolve whistleblower allegations that they paid kickbacks to referring physicians, the Justice Department said Thursday.
Midtown Imaging LLC, and former owners -- Midtown Imaging P.A., and PBC Medical Imaging -- were named as defendants in the whistleblower suit brought in 2009 by two former radiologists at the clinic. The lawsuit claimed that Midtown Imaging had alleged improper financial relationships with physicians and physician groups from 2000 to 2008 that violated the Anti-Kickback Statute and the Stark Law.
Under the civil settlement announced this week, whistleblowers Teresa M. Cortinas, MD, and Walter E. Wojcicki, MD, will receive $600,000, DOJ said.
“We are deeply satisfied with today’s settlement and encourage potential whistleblowers to come forward with evidence of wrongdoing affecting the Medicare program,” Wifredo Ferrer, U.S. Attorney for the Southern District of Florida, said in a media release. “We are committed to fighting fraud and abuse to help preserve scarce Medicare funds for those who need it the most, the sick and the elderly.”
Calls to Midtown Imaging by HealthLeaders Media were not returned on Thursday.
DOJ has used the False Claims Act to recover more than $5.7 billion since January 2009 in cases involving fraud against federal healthcare programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 are more than $7.3 billion.
Most job openings for physicians are in hospitals, while demand for private practice physicians is on the wane, a national survey shows.
Merritt Hawkins’ 2011 Review of Physician Recruiting Incentives tracks more than 2,660 physician recruiting assignments the Irving, TX-based physician recruiters conducted nationwide from April 1, 2010 to March 31, 2011. In that time, 56% of the physician search assignments featured jobs with hospitals, up from 23% five years ago. Only 2% of Merritt Hawkins’ search assignments featured openings for independent, solo practitioners, down from 17% five years ago.
"The era of the independent physician who owns and runs his or her practice is fading," said Travis Singleton, senior vice president of Merritt Hawkins, the nation’s largest physician search and consulting firm, in a media release. "Doctors today are more likely to be employees working for increasingly large health systems or medical groups."
For the sixth straight year family physicians were the search firm’s most requested type of doctor, followed by internists, hospitalists, psychiatrists, and orthopedic surgeons. Health reform and new delivery models such as Accountable Care Organizations are driving the need for additional family physicians and internists, Singleton said.
While the demand for primary care physicians is on the rise, it continues to be the lowest paying in medicine, according to the survey. Average base salary for a family practice physician was $178,000 in 2011, $183,000 for pediatricians, $205,000 for internists, and $217,000 for hospitalists.
Subspecialists continue to earn significantly more. Orthopedic surgeons had an average base salary of $521,000, for example. Gastroenterology had a base of $424,000.
Urology saw the largest year-to-year increase in base salary of any subspecialty, up from $400,000 in 2009/10 to $453,000 in 2010/11.
Five of the Top 20 recruited specialties in the survey saw their average base salary decline between 2009/10 and 2010/11. Family practice base salary fell from $200,000 to $197,000. Neurology fell from a base of $281,000 to $256,000. Hematology/Oncology fell from $385,000 to $369,000. Radiology fell from $417,000 to $402,000, and endocrinology fell from $219,000 to $218,000, the survey showed.
While health reform promotes new payment models based on quality and efficiency, Singleton said the survey shows that "real world" physicians are still compensated on volume-based formulas such as the number of patients they see, the amount of revenue they generate, or the number of work units they accrue. More than 90% of searches in the 2011 survey that featured physician production bonuses reward physicians for fee-for-service style volume, while less than 7% reward physicians for meeting quality of cost objectives.
"Quality and cost rewards may be the physician compensation standards of tomorrow, but patient volume, revenue or work units remain the standards of today," Singleton said.
Complete results of Merritt Hawkins 2011 Review of Physician Recruiting Incentives can be obtained by calling Merritt Hawkins at 800-876-0500.
Drug retailer Walgreens and Northwestern Memorial Physicians Group of Chicago said Wednesday that they will collaborate on a healthcare program that will share the results of the drug retailer's pharmacist clinical interventions with primary care physicians of selected patients.
The program is being implemented for Walgreens and Northwestern Memorial employees who have NMPG as their primary care provider, and focuses on those with hypertension, diabetes, asthma, and hyperlipidemia. Patients with these high-cost chronic diseases will receive point-of-care counseling or an intervention as part of the integrated services offered. Information from interventions will be provided to each patient's primary care physician, giving physicians access to important clinical information from Walgreens.
"This relationship is a great example of how healthcare organizations can work together to improve patient care while also benefitting our healthcare system at large," Kermit Crawford, Walgreens president of pharmacy, health and wellness, said in a media release. "We've already seen cases that speak to the effectiveness of the program and further demonstrate the important role our expansive network of pharmacists can play in the future of healthcare delivery."
NMPG is a multisite practice of primary care physicians on the medical staff at Northwestern Memorial Hospital, and who also practice at affiliated hospitals in Chicago, Northbrook and Lake County, IL.
"It's invaluable for our physicians to have a pharmacist as a clinical partner sharing this type of information that can be critical to a patient's health," said Daniel Derman, MD, president of NMPG and vice president, Northwestern Memorial. "This benefits those patients tremendously because now there's a richer conversation with their primary doctor that is supported by the pharmacy documentation. It's a more complete way of serving patients and it's particularly rewarding in this instance because those patients are also our employees."
Walgreens pharmacists and NMPG physicians have collaboratively developed an intervention plan for each disease, with questions designed to engage patients and help them understand their diseases.
"Many of our chronic disease patients tell us they see their pharmacist more often than they do their doctor," Crawford said. "Giving physicians further insight into patient behaviors and working with them to spend more time talking with patients can help reduce health care costs and, more importantly, improve a patient's overall health."
