Women health care executives earned $84,900 on average in 2000 while their male counterparts earned $104,300, according to the most recent survey conducted by the American College of Healthcare Executives. That is a $19,400 difference — 19 percent less overall. So says "A Comparison of Career Attainments of Men and Women Healthcare Executives: Findings of a National Survey of Healthcare Executives," the third report in a series that began in 1990, and is fielded every five years. There was no gain since 1990; in fact, there was a slight regression. Level of education and experience being equal, women earned 18 and 17 percent less, in 1990 and 1995 respectively, than men did.

The study's objective was to compare the attainments of men and women who had chosen managerial careers in general business and contrast findings with health care managers. In all, 1,601 members received the study; 906 responded, for a 57 percent overall response rate.

Among respondents, 25 percent of the men were CEOs, compared to 11 percent of the women. A higher proportion of men, 62 percent, were in general management positions compared to 46 percent of women. Women were more involved than men in specialized management areas including nursing services (10 percent vs. 0 percent), planning, marketing, and quality assurance (17 percent vs. 11 percent) and the continuum of care — ambulatory, home, and long-term care (7 percent vs. 4 percent).

The median salary for male and female business executives in general was higher than for their health care executive counterparts: Men in business earned on average $140,000, while women earned $105,600. However, the salary gap between men and women health care executives was less than in business (19 percent vs. 25 percent). While women have made some inroads into upper management positions, from a salary standpoint there is still inequity between the sexes.

Health care executive median salary by position ($1,000s)

Numbers at base of bars represent the number of respondents in that category.

SOURCE: FOUNDATION OF THE AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES

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.