Entries in Surveys & Reports (77)


Analysis of Managed Care Organization CEO Turnover Rates

By Clive Riddle, February 6, 2015

MCOL has just conducted an analysis of managed care organization CEO turnover during the past ten years, and found the turnover rates to be surprisingly high, given the importance of management stability and continuity for most organizations. One-fourth of managed care organization CEOs turned over during the past year,  one-third turned over during the past two years, one-half turned over during the past three years, two-thirds during the past five years and only one in seven remain from ten years ago.

That doesn’t mean that all turnover is attributed to firings or resignations.  More than half of the organizations analyzed are part of chain or system in which upward mobility within the organization is often the cause.

The analysis is based upon data from MCOL’s HealthQuest Publishers National Managed Care Leadership Directory, which lists health plans, provider networks, administrative organizations, PBMs, and specialty benefit organizations involved with managed care. The 2015 Directory was recently released. HealthQuest Publishershas released the annual directory since 1994. MCOL acquired HealthQuest Publishers in 2000.

Managed Care Organization CEO Turnover Percentage Compared to 2015 Incumbent

While 926 organizations are listed in the 2015 directory, only organizations also listed in applicable prior years were included in the analysis. Organizations are added or dropped in the directory over time based upon mergers & acquisitions, closures, consolidations and expansions.

The turnover rate percentage for each year, compared to the 2015 incumbent, for the MCOs that were also listed in each applicable year are indicated below. The number of applicable MCOs that are still listed in 2015 of course drops over time due to the factors listed above.


CEO Turnover

Applicable MCOs



















While the cause of turnover was not measured in the analysis, and upward mobility or other transfers within the same organization is undoubtedly a significant factor, disruption at the CEO level presents significant challenges for managed care organizations during this disruptive era of healthcare reform, regardless of the reasons for the change.


Lung Cancer Misperceptions: The “Any One Any Lung” Survey

By Clive Riddle, November 21, 2014

Misperception surrounding a disease can impact treatment, care, funding, and more. So it would seem is the case with lung cancer, as just highlighted in a new survey “Any One Any Lung” Survey sponsored by Novartis Oncology. The online survey was conducted by Harris Poll involving 10,111 adults from 10 countries including the U.S., 84% responding that they know little or nothing about lung cancer. The stated goal of the campaign surrounding the survey is to “to raise global awareness of lung cancer as a complex disease that can affect anyone, regardless of gender, age or smoking history.”

Stefania Vallone from the organization, Women Against Lung Cancer in Europe, has this to say in conjunction with the survey: “While patient advocates around the world have played an important role in raising lung cancer awareness, misinformation continues to surround this disease, creating barriers to treatment and patient care and often generating negative attitudes towards patients affected by this disease. We are calling on the general public to help correct misperceptions around lung cancer and highlight the disease for what it truly is, a complex and heterogeneous disease with many causes that can affect anyone, regardless of age, gender or smoking history, and that over the past 30 years has doubled in incidence and mortality rates, especially among women."

Here’s results from the survey that Novartis shared to make their case regarding misperceptions:

  • 59% didn't realize that lung cancer causes the most cancer deaths worldwide
  • 55% of adults feel that people with lung cancer are mostly or fully responsible for causing their cancer, compared to the levels perceiving the same about people diagnosed with prostate (12%), colon (14%) or breast (11%) cancer.
  • 17% believe that all people who are diagnosed with lung cancer are current or former smokers
  • 75% immediately think smoking is the cause when they hear someone has lung cancer (approximately 10 – 15% with the disease have never smoked)
  • 40% say there is little support or compassion for people with lung cancer in their country
  • Only 23% recognize changes in genetic makeup as a cause of lung cancer
  • 6% believe no one under the age of 40 can get lung cancer
  • 19%) recognize that therapies targeted to a specific change in genetic makeup can be used to treat lung cancer, significantly less than mention chemotherapy delivered directly to into the blood, (68%), radiation (66%), surgery (61%) and therapies that help the body's immune system fight cancer (52%)

Surveying Physicians on Their Views of the ACA

By Clive Riddle, October 17, 2014

The Medicus Firm, a national healthcare recruiting firm has just released results regarding health reform, from their 11th annual Physician Practice Preference Survey. This year’s survey shows an uptick grades doctors give the Affordable Care Act, but a still overall negative review. 2,272 physicians and advanced practice providers from 19 specialties and all 50 states participated in this year’s survey.

When asked to give the ACA an overall grade, 8.6% awarded an “A”, up from 6.3% last year. Meanwhile, 22.35% graded the ACA an “F” this year, down from 30.2% a year ago.

The survey went on to ask doctors to rate the ACA on specific objectives, such as improving efficiency of healthcare, improving access to healthcare, improving quality of healthcare, and decreasing healthcare costs. Medicus reports that “the best and most improved grades were awarded for ‘improving access to healthcare’, with a resounding 23.4 percent giving the ACA an ‘A’ in this objective, up from 11.8 percent last year. Additionally, 27.11 percent of physicians gave the ACA a ‘B’ for improving healthcare access. Only 13.68 percent of respondents failed the ACA in this category, down from 23.6 percent who gave it an ‘F’ last year for this objective. The objective receiving the lowest grades was ‘improving efficiency of healthcare.’ However, even this category showed some improvement over last year. Only about 7 percent of physicians gave the ACA an ‘A’ for improving efficiency, which is up slightly from 5.6 percent last year. Furthermore, 29.73 percent of physicians gave the ACA an ‘F’ for improving efficiency, which is down from 35.4 percent who gave it a failing grade in this category last year.”

It should come as no surprise that from the onset, physicians would view the ACA negatively. Perhaps it should also not be surprising that some of them would view things more positively once the core of the Act was finally implemented. Jim Stone, President of The Medicus Firm, tells us "Physicians seem to have become slightly more positive about the ACA compared to last year's survey. As of last year's survey, the ACA had not yet been fully implemented, although many aspects of the legislation were already in motion. This year's survey was conducted after the ACA was in full effect for several months, and four years after its passage into law. Unfortunately, the grades on the whole are not very positive, so it's good that there is some improvement in physicians' perceptions of the effectiveness of the ACA."

The Medicus Firm isn’t the only organization surveying physicians on their views of the Affordable Care Act. Physicians Practice Magazine conducts the annual Great American Physician Survey, which this year had 1,311 respondents. Their results, announced in August, included this reform question:
“Which statement best describes your personal feelings about the Affordable Care Act, in terms of its effect on patient access to care: [A] I think it’s been great for Americans (18.9%); [B] I think it’s mostly good, but not all good; and [C] I think it has done a disservice to Americans (39.2%).”

Finally, The Physicians Foundation commissioned Merritt Hawkins, a physician search and consulting firm, to conduct a survey of 20,000 physicians, with the resulting report 2014 Survey of America’s Physicians: Practice Patterns and Perspectives released last month. The survey included a question similar to The Medicus Fund’s grading of the ACA, with Merritt Hawkins finding that “when asked about what grade physicians would give the Affordable Care Act (ACA), 46 percent give a D or F grade. Younger (ages 45 or lower), employed physicians were more inclined to give the ACA favorable marks than older (46 or higher), private practice owners. In fact, 63 percent of younger physicians (ages 45 or lower), would give the ACA a grade of C or above.”


Study on Health Plan Shopping – Reluctants, Premiums and Defaulters

By Clive Riddle, October 10, 2014

Vitals – who provide a consumer health information platform including doctor ratings and reviews, has released a study on health plan shoppers in open enrollment season, and lumping many of the shoppers into three categories: (1) The Reluctant; (2) The Premium; and (3) The Defaulter. Vitals study was based on their August online survey of 1,000 adults.

The big takeaways from their survey?

  • 80 percent of respondents said they were not planning to switch their insurance this year.
  • More than 1 in 5 are dissatisfied with their plan.
  • Nearly one-third said they were unhappy with the value for cost of their plan.
  • 27 percent were unhappy with customer support services
  • 9 percent were unhappy with the lack of quality network doctors and hospitals

So what the heck are Vitals’ trio of Reluctants, Premiums and Defaulters?

Vitals classifies Reluctants as age 30-44 with no dependents and household income under $25k, who are satisfied with their plan provider network but not the plan value. Vitals says “the Reluctant doesn’t want to buy insurance and isn’t satisfied with their plan – if they even have one. They’re more likely to have an HMO to keep costs down, but still say they’re not getting a good value for cost. Over 1 in 4 will switch their health plan during open enrollment this year. Their main gripe: Cost. They index higher for cost increases over the past year and report being surprised more by health care costs this year, compared to last year.”

Vitals classifies Premiums as age 45-60 with dependents and household income over $100k, who also are happiest with the network and unhappiest with plan value. Vitals tells us “the Premium is most likely to have Cadillac-like coverage for their health care. They index higher for employer-provided health care and PPO-type plans, which offer the most flexibility. Premium shoppers are most likely to say they’re happy with their health insurance – only 5 percent will switch during open enrollment! And they uniformly agree they have adequate access to medical care.”

Finally, Vitals classifies Defaulters as any age adult (but often age 60+) with no dependents and household income of $50 - $99k. They define the Defaulter as someone “on cruise control and typically doesn’t review or change their plan from year to year.”


Scorecard on Value Based Payments

By Clive Riddle, October 3, 2014

Catalyst for Payment Reform has just released their second annual National Scorecard and California Scorecard on value based payments and payment reform made to providers by purchasers, funded by The Commonwealth Fund and the California HealthCare Foundation.

The universe they utilized to track and measure provider payments was based on the National Business Coalition on Health’s eValue8 health plan survey platform, in partnership with NBCH and these business coalitions: the Colorado Business Group on Health, HealthCare 21, the Memphis Business Group on Health, the Mid-Atlantic Business Group on Health, the Northeast Business Group on Health, the Pacific Business Group on Health, and the Washington Health Alliance.

What meets their definition of value oriented payments? They say they are in-network payments that are “either tied to performance or designed to cut waste” and that 40% of commercial payments meet this definition. What makes up the other 60%? They say payment types without quality incentives that include “traditional feefor-service (FFS), bundled, capitated and partially capitated payments.”

What comprises the 40% that is value oriented? Quality incentive driven Bundled Payments (0.1%) + Non FFS Shared Savings (0.2%) + Non FFA Non-Visit Payments (0.6%) + Shared Risk (1.0%) + Partial or Condition Specific Capitation (1.6%) + FFS and Shared Savings (2.0%) + FFS Based Pay and P4P (12.8%) + Full Capitation (15.0%) + All Other (6.7%) = 40.0%.

Here’s more of the numbers shared in this year’s scorecard:

  • 53% of value-oriented payments put providers at some financial risk if they fail to improve care or spend over budget
  • 38% of payments to hospitals are value-oriented,
  • 10% of payments to specialists and 24% of payments to primary care physicians are value oriented
  • Of these value-oriented payments to physicians, 71% of the total goes to specialists, and 29% to PCPs
  • 15% of participating health plans’ patient members are formally “attributed” to a provider participating in a payment reform contract