2010 Potpourri XXXVII

According to a survey by the Hay Group, more physician practices are tying overall compensation to performance, with incentives making up a greater portion of total compensation.  Patient satisfaction and quality are the major factors used in the plans.  Base salary increases will be relatively modest in 2011, 2.9% for hospital-employed doctors and 3.3% for group practice ones.   (Hay Release)

The National Association of Insurance Commissioners released its latest medical loss ratio calculation draft, which is largely consistent with the early “blank” release.  Controversial issues remain, such as how to treat agent commissions, fraud and abuse expenses and taxes and whether the calculation is national or state-based.  The NAIC is taking comments on the draft.  When finalized, the Administration will have its say on the proposal.  Highly politicized to say the least.   (NAIC MLR Draft)

Hewitt is the latest benefit consulting firm to release its expectations for 2011 health plan costs in the private sector.  The company anticipates an 8.8% average increase, the highest in five years.  Employees’ premium share will be 22.5%, up 12% and their out-of-pocket costs will rise about 12.5%.  In a decade, premiums will have more than doubled and employees’ overall share of costs will have tripled.  The main factors for the 2011 increases, according to Hewitt, are more catastrophic claims and the changes mandated by health reform.  In 2010 most California areas had higher than average cost increases, while Dallas, Portland and Washington, D.C. had lower than average ones.  Employers are getting aggressive about ensuring dependent eligibility and are consolidating vendors, eliminating ones who can’t demonstrate savings.   (Hewitt Release)

The Charlotte Observer carries a story regarding a meeting on the effect of the internet on physician practices.  Most doctors are uncertain how to respond to social media opportunities.  They want to correct misinformation that may be posted by patients, but fear liability and don’t have time.  Other physicians are concerned about information patients get from websites and about the time it takes to respond to questions raised by what patients find on the internet.   (Online Advice Article)

The journal Dermatology Research and Practice reports on a pilot study using text messaging to help teenagers deal with atopic dermatitis.  The messages gave medication reminders and education.  Treatment adherence, self-care, skin severity and quality of life all improved from before the intervention and the participants were satisfied with the system.  This was, however, not a randomized trial.   (Derm. Research Article)

Wonder why health care costs are high?  One reason is that doctors do everything they can to keep lower-charging providers from offering a wide range of services.  You may recall an earlier post on nurse anesthetists’ quality being as good as physicians’.    CMS has allowed states to decide if trained nurses can administer anesthesia without physician supervision to Medicare beneficiaries.  Colorado decided they could and promptly is sued by the state anesthesiologists.  They claim quality is endangered but the only thing threatened is their income.   (Denver Post Story)