Apprehensive, Many Doctors Shift to Jobs With Salaries

Workers' Compensation will soon be impacted by the full economic force and effect of The Affordable Care Act. The economics of the costs of the delivery of medical care will soon be the issue that determines whether workers' compensation continues as a viable program. Today's post that is hared from the NYTimes.com highlights the issue. Dr. Suzanne Salamon, with a patient at Beth Israel Deaconess Medical Center in Boston, said she has had trouble filling a prestigious fellowship because of relatively low salaries. Katherine Taylor for The New York Times American physicians, worried about changes in the health care market, are streaming into salaried jobs with hospitals. Though the shift from private practice has been most pronounced in primary care, specialists are following. Last year, 64 percent of job offers filled through Merritt Hawkins, one of the nation’s leading physician placement firms, involved hospital employment, compared with only 11 percent in 2004. The firm anticipates a rise to 75 percent in the next two years. Today, about 60 percent of family doctors and pediatricians, 50 percent of surgeons and 25 percent of surgical subspecialists — such as ophthalmologists and ear, nose and throat surgeons — are employees rather than independent, according to the American Medical Association. “We’re seeing it changing fast,” said Mark E. Smith, president of Merritt Hawkins. Health economists are nearly unanimous that the...

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Massachusettes Senator Seeks to Double Payment for Workers Killed on the Job

Following the deaths of two workers last month at Boston construction and shipping sites, Senator Brian A. Joyce and the Massachusetts Coalition for Occupational Safety and Health (MassCOSH) are renewing their calls for passage of Joyce’s Bill, "The Families of Fallen Workers Burial Act," which would double the benefit amount paid by workers’ compensation when a loved one is killed at work. “The amount paid out to grieving families has remained stagnant for decades while the cost of a burial has risen steadily,” said Joyce. “These families are going through enough already without the additional stress of coming up with thousands of dollars to put their loved ones to rest.” According to the 2010 funeral price survey by the National Funeral Directors Association, the average funeral cost for an adult funeral is $7,775. With cemetery plot, grave marker, flowers or obituary notices, the “regular adult funeral” cost is at least $9,000. Joyce’s bill would increase the benefits allotment from $4,000 to roughly $8,000 (eight times the average weekly wage in the Commonwealth) and tie future increases to inflation. “The Families of Fallen Workers Burial Act will ensure that no family has to shoulder the financial burden of a burial,” said MassCOSH Executive Director Marcy Goldstein-Gelb. “The increase adds up to very little for the workers’ compensation insurance system and will mean a huge difference...

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Building an Accountable Care Organization and Its Impact on Workers' Compensation

Medical cost containment is a universal problem for insurance companies and employers. For those states with fee schedules indexed to the Medicare system, limitations are in place. For those jurisdiction where fee limitations are not in place, ie. NJ,costs may continue to soar without containment. Today's post was shared by NEJM and comes from blogs.hbr.org

Suppose for a moment that you are an administrator in an organization that provides health care and your job is on the line for delivering both savings and improved care. Because you want to be part of the solution to the health-care-cost problem, you have signed contracts with payers that reward your institution or system for reducing the costs of care. These same contracts require you to pay a penalty if the costs of care go up more than inflation. What would be your first, second, and third move? This is not a hypothetical question. More than 300 hundred administrators of accountable care organizations (ACOs) across the United States are facing it. My team at Partners HealthCare in Boston is faced with this exciting (and daunting) challenge. Having signed shared-savings contracts with both commercial payers and Medicare, our CEO, Gary Gottlieb, established a Population Health Management unit. A major focus of our work is to achieve shared savings in our contracts. That means controlling costs for the populations cared for by our primary care physicians. Since doctors and hospitals within Partners bill for a majority of the care these patients receive, you could say our success depends on reducing the income of our colleagues. Harvard Business School’s Clayton Christensen has taught us this is not possible — that an organization will not cannibalize itself. So when we go knocking on...

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Lead Paint Makers Could Face The Same Fate As Big Tobacco

Today's post was shared by WCBlog and comes from www.huffingtonpost.com

A lawsuit in California that seeks some $1 billion from former lead paint manufacturers is far from the first attempt to hold the industry liable for decades of poisoning children and leaving lingering contamination. But experts such as Richard Rabin -- who directed a lead poisoning registry at the Massachusetts Department of Labor for over 20 years -- think the case just might be the first to finally succeed, marking the end of a long losing streak. "My ideal hope is something along the lines of what happened with tobacco," said Rabin, who initiated the inaugural trial against the lead paint industry more than 25 years ago. "It's gone on and on and on," he said of lead litigation, even as research uncovering lead's dangers, "keeps coming and coming." After fending off lawsuits since the 1950s, the tables eventually turned on big tobacco, forcing the industry to pay out hundreds of billions of dollars in the late 1990s. At that point, it had become common knowledge that the industry was well aware of the addictive qualities and the health hazards of their products. In 1987, with nearly a century of documented dangers accumulated on childhood lead poisoning, a lawsuit -- spurred by Rabin -- was filed on behalf of a Boston girl exposed to lead paint as a toddler. "I want to be a lawyer, but I don't think I can do the studying,'' Monica Santiago told The New York Times in 1988, then 15 years old. ''In school they teach me, but I forget. The kids call me dumb. Sometimes when I do...

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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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