How well physicians fit in with the corporate culture of provider organizations such as hospitals and group practices influences whether they’ll stay or even whether they’ll come aboard in the first place, according to a study by Cejka Search and Physician Wellness Services, a company that tries to help provider organizations run more smoothly. “When physicians feel a lack of cultural fit, it manifests itself in various ways, from feelings of anger, disengagement, and cynicism to, ultimately, leaving their jobs,” says the company’s “Organizational Cultural Survey.” It adds that “These consequences of poor cultural fit are [of concern] at a time when physician engagement has never been more important in the changing landscape of health care.”

Doctors who have to stay put because of family concerns, location preference, or stage in career find themselves increasingly unhappy, says the survey of 2,262 physicians and 123 provider administrator respondents. Responses were organized on a 10-point Likert scale.

Lori Brostrom, vice president for marketing at Physician Wellness Services, describes cultural fit as “when the people working at an organization believe in and are in step with the cultural attributes that reflect the organization’s culture.”

Physicians who perceive a lack of cultural fit “are also rejecting employment with organizations that don’t meet their expectations [regarding] organizational culture. “

My expectations of cultural fit have been a determining factor in accepting a practice or job opportunity

Percent of respondents


Lack of cultural fit has prompted me to leave a practice or job

Percent of respondents


Source: “Organizational Cultural Survey,” Physician Wellness Services and Cejka Search

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.