Medical school enrollment, it is hoped, will rise to meet the ever-growing demand for physicians, according to a survey by the Association of American Medical Colleges (AAMC). “First-year medical school enrollment in 2017–2018 is projected to reach 21,434 — a 30% increase from 2002–2003,” says the survey, which does not estimate what specialties students will pick.

Medical schools that opened since 2002 will account for 31% of that growth, says the report, “Results of the 2012 Medical School Enrollment Survey.” Most of the data were collected in an e-mail survey sent last September to deans of 130 medical schools. For schools that did not respond, enrollments from the 2011 survey were used. Data were obtained for three schools that were in the process of applying for accreditation by the Liaison Committee on Medical Education. “Without the three applicant schools Charles E. Schmidt College of Medicine at Florida Atlantic University, Commonwealth Medical College, and Virginia Tech Carilion School of Medicine. currently in the pipeline, enrollment growth is not projected to reach the 30% target until after 2020.”

Projected first-year enrollment growth through 2020 (000s)

More DOs

There will still be many more MDs than DOs in the country, but the growth rate for DOs is expected to outpace that for MDs. Researchers estimate that by 2017, total first-year enrollment for DOs will be 6,675, a 125% increase over the baseline 2002 enrollment. Enrollment in MD programs will grow by about 30%.

DO growth since 2002 (000s)

Source: “Results of the 2012 Medical School Enrollment Survey,” Association of American Medical Colleges, May 2013.

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.