DOCTORS' INCOMES FALL AS MANAGED CARE GROWS

PEDIATRICS ◽  
1996 ◽  
Vol 97 (1) ◽  
pp. A28-A28
Author(s):  
J. F. L.
Keyword(s):  
Health Care ◽  
American Medical Association ◽  
Managed Care ◽  
Federal Government ◽  
Health Care Providers ◽  
Care Providers ◽  
Front Line ◽  
Annual Survey ◽  
First Time ◽  
Managed Care Organizations

For the first time in the 14 years that the American Medical Association (AMA) has been keeping track, doctors' incomes are falling as managed care organizations tighten their grip on the nation's health care system. The median earnings of all physicians, from front-line general practitioners to highly-paid specialists like brain surgeons, dropped 3.8% last year to $150,000, from $156,000 in 1993, according to preliminary results from the AMA's latest annual survey. The pressure on pay comes mostly from outside the profession: employers are demanding lower insurance premiums, and insurers are leaning on health care providers to cut costs. But another factor is at work from within: an explosion in America's doctor population over the last 30 years. The number of physicians has soared to 660,582 today, or 252 for each 100,000 Americans—not counting federal government doctors—compared with 266,045, or 139 for each 100,000 in 1965.

EMTALA: OIG/HCFA Special Advisory Bulletin Clarifies EMTALA, American College of Emergency Physicians Criticizes it

2000 ◽  
Vol 28 (1) ◽  
pp. 90-92 ◽  
Author(s):  
Jeffey Rowes
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Financing ◽  
Care Providers ◽  
Emergency Physicians ◽  
Emergency Rooms ◽  
Active Labor ◽  
Public Emergency ◽  
Health Care Law ◽  
Managed Care Organizations

In December 1998, the Office of Inspector General (OIG) and the Health Care Financing Administration (HCFA) solicited comments from health care providers regarding the federal anti-patient dumping statute, the Emergency Medical Treatment and Active Labor Act (EMTALA) (42 USCA §1395dd). EMTALA is a federal health care law of unprecedented breadth—the first universal benefit guaranteed by the federal government. It requires Medicare-participating hospitals with public emergency rooms, emergency physicians, and ancillary surgical and medical specialists to render adequate stabilizing treatment to whoever requests it. The 1998 Special Advisory Bulletin (63 FR 67486-01) sought input on four principal dimensions of EMTALA: (1) the statutory obligation to furnish adequate medical screening to anyone who visits an emergency room; (2) the responsibilities of health care providers towards enrollees of managed care organizations (MCOs); (3) the prior authorization and payment rules for Medicare and Medicaid; and (4) what practices would promote hospital compliance with EMTALA.

scholarly journals Postpartum Visit Attendance Increases the Use of Modern Contraceptives

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Saba W. Masho ◽  
Susan Cha ◽  
RaShel Charles ◽  
Elizabeth McGee ◽  
Nicole Karjane ◽  
...  
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Care Providers ◽  
Contraceptive Use ◽  
Care Organization ◽  
Modern Contraceptive ◽  
Care Providers ◽  
Good Opportunity ◽  
Modern Contraceptive Use ◽  
Managed Care Organization

Background. Delays in postpartum contraceptive use may increase risk for unintended or rapid repeat pregnancies. The postpartum care visit (PPCV) is a good opportunity for women to discuss family planning options with their health care providers. This study examined the association between PPCV attendance and modern contraceptive use using data from a managed care organization. Methods. Claims and demographic and administrative data came from a nonprofit managed care organization in Virginia (2008–2012). Information on the most recent delivery for mothers with singleton births was analyzed (N = 24,619). Routine PPCV (yes, no) and modern contraceptive use were both dichotomized. Descriptive analyses provided percentages, frequencies, and means. Multiple logistic regression was conducted and ORs and 95% CIs were calculated. Results. More than half of the women did not attend their PPCV (50.8%) and 86.9% had no modern contraceptive use. After controlling for the effects of confounders, women with PPCV were 50% more likely to use modern contraceptive methods than women with no PPCV (OR = 1.50, 95% CI = 1.31, 1.72). Conclusions. These findings highlight the importance of PPCV in improving modern contraceptive use and guide health care policy in the effort of reducing unintended pregnancy rates.

scholarly journals Health Care Network Formation and Policyholders' Welfare

2011 ◽  
Vol 11 (2) ◽  
Author(s):  
David Bardey ◽  
Jean-Marc Bourgeon
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Care Providers ◽  
Network Formation ◽  
Care Quality ◽  
Care Organization ◽  
Care Providers ◽  
Horizontal Differentiation ◽  
Care Network ◽  
Health Care Network

Abstract We develop a model in which two insurers and two health care providers compete for a fixed mass of policyholders. Insurers compete in premium and offer coverage against financial consequences of health risk. They have the possibility to sign agreements with providers to establish a health care network. Providers, partially altruistic, are horizontally differentiated with respect to their physical address. They choose the health care quality and compete in price. First, we show that policyholders are better off under a competition between conventional insurance rather than under a competition between integrated insurers (Managed Care Organizations). Second, we reveal that the competition between a conventional insurer and a Managed Care Organization (MCO) leads to a similar equilibrium than the competition between two MCOs characterized by a different objective, i.e. private versus mutual. Third, we point out that the ex ante providers' horizontal differentiation leads to an exclusionary equilibrium in which both insurers select one distinct provider. This result is in sharp contrast with frameworks that introduce the concept of option value to model the (ex post) horizontal differentiation between providers.

Family planning clinic patients: their usual health care providers, insurance status, and implications for managed care

2000 ◽  
Vol 27 (1) ◽  
pp. 25-33 ◽  
Author(s):  
Susan Sugerman ◽  
Neal Halfon ◽  
Arleen Fink ◽  
Martin Anderson ◽  
Laurie Valle ◽  
...  
Keyword(s):  
Health Care ◽  
Family Planning ◽  
Managed Care ◽  
Health Care Providers ◽  
Insurance Status ◽  
Care Providers ◽  
Family Planning Clinic

scholarly journals Significance of Pharmacist’s Role in Keeping the People Healthy in Pandemic Situations

2021 ◽  
pp. 75-83
Author(s):  
Suruchi Singh ◽  
Satish Kumar Sharma
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Health Conditions ◽  
Care Providers ◽  
Front Line ◽  
Health Concerns ◽  
The People ◽  
Role Players ◽  
Front Line Workers

As the lockdown situation progressed in COVID-19 pandemic, national pharmacy role players became major front line workers for maintaining accessibility of health care utilities. Pharmacists have been handling in-house deliveries of essentials, reducing burden on health care, along with attending patients with other ailments. Since pharmacists are representatives directly associated with public health concerns, there is need for disseminating awareness in pharmacists to maintain the health conditions of the people living in the pandemic situation. Pharmacy Colleges and representatives of public health interests were subjected to systematic literature review regarding publicly reported pharmacist positions. It is concluded that respondents having much experience are intended to perceive a pharmacist's position as being essential to health care providers relative to the individuals who have less experience. The findings of this research can be beneficial for educating pharmacists in order to achieve the goal of keeping the people healthy in the pandemic situations.

scholarly journals Emotional Responses And Perceived Stressors Of Frontline Medical Staffs In Case Of Addis Ababa Covid-19 Treatment Centers And Obstetrics Emergency And Abortion Care Clinic, Ethiopia; Analytical Cross Sectional Study

2020 ◽  
Author(s):  
Mebratu Kebede ◽  
Dereje Demissie ◽  
Dessalegn Guddu ◽  
Michael Haile ◽  
Zebenay Bitew ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Emotional Response ◽  
Addis Ababa ◽  
Emotional Responses ◽  
Care Providers ◽  
Front Line ◽  
Care Clinic ◽  
Abortion Care

Abstract Background: the rapid spread of COVID-19, its lethality in severe cases and the absence of specific medicine poses a huge threat to human life and health, as well as huge impact on the mental health. Facing this critical situation, health care workers on the front line who are directly involved in the diagnosis, treatment, and care of patients with COVID-19 are at risk of developing psychological distress and other mental health symptoms including emotional disturbance.Objective: the aim of this study will be to assess the current state of emotional responses and perceived stressors of frontline medical staffs in case of Addis Ababa COVID-19 Treatment Centers and obstetrics emergency and abortion care, Ethiopia 2020Methods: Hospital based comparative cross-section study design was conducted by using self-administered questionnaire survey from June 1st to 30th of 2020 among 133 and 266 frontline medical staffs from obstetric emergency and abortion care clinic and COVID-19 treatment centers respectively. The data were collected after getting written consent from each participant and it entered into the computer using Epi-data version 7, then exported to SPSS version 20 for further analysis. Descriptive analysis was done using frequencies & percent. All independent determinants with P-value <0.05 were used to identify important predictors of emotional responses and perceived stressors. Result; A total of 399 frontline medical staffs were included in the study. The mean age of the respondents of those who were working in obstetrics emergency and abortion care clinic was 27.47 (SD=3.46) years and it was 28.12 (SD=4.09) years for the other groups. This study revealed that, 72.9% and 5.6% of the study participant from obstetrics emergency and abortion clinic and COVID-19 treatment centers had a positive emotional response, respectively. Factors such as having a low level of motivational factors (AOR 2.78, 95% CI (1.13, 6.84)), being a nurse (AOR 10.53, 95% CI (1.31, 85.26)) and working at triage (AOR 8.61, 95% CI (1.15, 64.81))) had statistically significant association with negative emotional response.Conclusion; The current study revealed that a high proportion of front line a negative emotional responses had negative emotional response. Further, almost all of the medical staffs working in COVID-19 treatment centers and at obstetrics emergency and abortion care unit had perceived the outbreak related stressors. So, providing comprehensive psychological support is warranted for health care providers working in such kinds of department or units.

Managing Care in the New Era of “Systems-Think”: The Implications for Managed Care Organizational Liability and Patient Safety

2001 ◽  
Vol 29 (3-4) ◽  
pp. 290-304 ◽  
Author(s):  
Alice A. Noble ◽  
Troyen A. Brennan
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Care Providers ◽  
Medical Error ◽  
Financial Incentives ◽  
Care Delivery ◽  
Care Providers ◽  
Dominant Form ◽  
New Era ◽  
The Individual

Three major trends in American health policy are intersecting in a fascinating way. First, managed care has grown to become the most dominant form of health-care delivery, leading to reductions in health-care costs as insurers are able to influence health-care providers with financial incentives. Second, the present growth of managed care has slowed, almost to a standstill, largely on account of consumers questioning what effects these financial incentives are having on the care of patients — questioning that has been expressed in particular through lawsuits against managed care companies.Third, we are experiencing a renewed interest in the existence of medical error and how it may be reduced as a result of the Institute of Medicine’s (IOM) report, To Err Is Human: Building a Safer Health System. The most important aspect of this renaissance in error reduction has been its emphasis on health care as a system that can be made better through system-oriented change. The most frustrating aspect is that the IOM did not endorse change in malpractice liability, which consistently puts the impetus for reducing medical error on the individual provider rather than the system as a whole.

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