News Briefs
News Briefs
Integrated performance measures announced
This American Medical Association, the Joint Commission on Accreditation of Healthcare Organizations, and the National Committee for Quality Assurance have announced their intentions to produce integrated performance measurement sets that will be used across health plans, provider organizations, and practitioners.
Currently, each organization provides its own set of performance measures. Under the new process, the Performance Measurement Coordinating Council (PMCC), a jointly sponsored organization, will be phased out and the three sponsors will work together to produce the performance measures. The PMCC was formed by the three organizations to coordinate activities so that a set of performance measures would relate to each other whether they apply to a physician, a hospital, or a managed care organization.
In addition to a consensus statement on general performance measures and a consensus on attributes for performance measures, the PMCC has produced a "Consensus Statement on Performance Measure for the Management of Adult Diabetes."
The three sponsoring agencies intend to assume responsibility for ongoing PMCC projects to produce similar measures for cardiovascular disease, pregnancy and neonatal care, and other clinical conditions.
Pay doesn’t keep pace with productivity
The good news is that physician compensation rose 3.39% for primary care and 6% for specialists last year. The bad news is that physician gross charges rose 11.5% and 8.51% respectively during the same time.
The figures are included in the Medical Group Management Association’s (MGMA) Physician Compensation and Production Survey: 2000 Report, a report containing information from 27,985 providers in 97 specialists and 17 midlevel provider specialties at 1,369 practices.
According to the report, although primary care physicians and some specialists received substantial pay increases last year, overall compensation has been sluggish in the past five years. For example, primary care physicians experienced only an average of 7.98% increase over the past five years, and specialists’ pay went up only 13.86%.
The survey also showed that starting median salaries for several specialties jumped significantly in the past year. For instance, the starting salary for invasive cardiology was $212,292 in 1999 compared to $195,630 in 1998. Cardiovas-cular surgeons started at $291,292 compared to $214,193 in 1998.
The report is available from the MGMA at (877) 275-6462, ext. 888, or by visiting the organization’s Web site at www.mgma.com.
Physicians cite delays in claims processing
Fully 83% of New Jersey physicians report delays by HMOs in processing claims, according to a survey by the Medical Society of New Jersey. The findings were reported in the September issue of the organization’s journal New Jersey Medicine. The study was conducted just before the state’s new prompt payment law took effect. The law stipulates that HMOs must pay electronic claims within 30 days and manual claims within 40 days.
The respondents reported that most HMOs routinely took more than 30 days to pay claims that were filed electronically. Only 13% of the respondents reported receiving interest payments on late claims. "This study validates the concerns and dilemmas facing physicians and proves that some HMOs have been more efficient in payment methods than others. Overall, there is a lot of work to be done to satisfy the needs of patients and physicians," says Walter Kahn, MD, MSNJ president.
HIPAA, e-business top IT priorities
Health care information technology executives are most concerned with establishing e-business, compliance with the Health Insurance Portability and Accountability Act (HIPAA), and improving their information technology operations, a study shows. The telephone study, conducted by Porter & Associates, an information technology research firm in Alpharetta, GA, shows that health care information technology executives are concerned about the emerging consumer market, the need for security, and the return on investment for new technology.
Most of the respondents say that they will need outside help to address these priorities.
"Demand for outsourced IT [information technology] services continues to be high for health care. Almost half of the healthcare organization decision makers we spoke to in our recent blind survey say they still need outside resources to address their current IT priorities this year," says Bill Porter, chief executive officer of Porter & Associates.
HMOs anticipate increases in premium rates
The nation’s HMOs anticipate an 11.4% increase in premium rates and a 2% decrease in their medical loss ratios in 2001, according to Sherlock Company’s annual HMO Pricing Survey. Using the data from the survey, Sherlock calculates that the HMOs are expecting an 8.8% increase in payments for medical care next year.
The increase in premium rates charged customers is high, compared to the previous year. The HMOs expected a 10.6% increase this year, compared with 8.3% in 1999, 4.6% in 1988, and 2.6% in 1997. More information is available on Sherlock’s Web site: www.sherlockco.com.
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