Healthcare News of Note:  The healthcare sector was targeted by nearly 24% of cyber-attack activity in 2022 

• When it comes to the number of malicious cybersecurity events targeting customers in the Americas, the healthcare industry is second, just behind finance. 
• Contrary to its previously announced plans, the U.S. Department of Justice is not pursuing a further challenge to UnitedHealth Group’s purchase of Change Healthcare. 
• The average pay for physicians decreased 2.4% in 2022, according to the 2023 Physician Compensation Report. 

Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.     

1. Healthcare is the second-most attacked industry in the Americas when it comes to malicious cybersecurity activity 

Regarding the number of malicious cybersecurity events targeting customers in the Americas, the healthcare industry is second, just behind finance, according to Radware’s 2022 Global Threat Analysis Report. 

“The cyber landscape was marked by a sharp increase in malicious activities and DDoS attacks, particularly targeting organizations in the financial, healthcare, and technology sectors,” wrote the report authors. “Radware’s Cloud DDoS Service recorded a 233% growth in blocked malicious events compared to the previous year, with the number of DDoS attacks growing by 150%.” 

Key findings 

In the Americas in 2022, these were some of the trends seen in attack activity per industry: 

• Finance was the target of 31.5% of attack activity, with the frequency of attacks growing in line with global growth of 2.4% compared to 2021. 
• Healthcare represented 23.9% of attack activity and experienced a slight increase of 1.7% compared to 2021. 

• Technology was the third most attacked industry in the Americas, at 17.2%, with a slight increase over 2021. 
• Communications was the next-most attacked industry at 12.3%, followed by research & education at 4.41% and government at 2.75%. 

“The increase in cyberattacks in 2022 can be attributed to a number of geopolitical events that took place during the year,” wrote the authors. “The ongoing tensions between major world powers led to an increase in state-sponsored cyberattacks and espionage activities. Additionally, the ongoing global shift towards digitalization and remote work due to the pandemic created new vulnerabilities for attackers to exploit.” 

2. DOJ declines to pursue a further challenge to UnitedHealth Group’s acquisition of Change Healthcare 

No antitrust-related obstacles remain to jeopardize the union between UnitedHealth Group (UHG) and Change Healthcare, with the U.S. Department of Justice (DOJ) having withdrawn its latest challenge. 

Last September, UHG prevailed in an antitrust case in D.C. federal court. UHG and Change then closed the $13 billion merger (which included the assumption of more than $5 billion in debt), but DOJ in November said it would appeal the decision and potentially seek to unwind the transaction. 

As reported by the Law360 blog, however, DOJ in March filed a stipulation of voluntary dismissal with the D.C. Circuit Court of Appeals. The statement did not provide a reason for the department’s decision to end the case. 

Change Healthcare is being integrated with UHG subsidiary Optum Insight, which offers first-pass claims-editing services. DOJ had argued, in part, that the combination could create a monopoly in the market for such services. The companies said they would bypass any such concerns by divesting Change’s first-pass claims-editing product, ClaimsXten. 

The American Hospital Association (AHA) had opposed the merger since it was agreed to in early 2021, writing in a March 2021 letter to DOJ that the transaction “threatens to reduce competition for the sale of healthcare information technology services to hospitals and other healthcare providers, which could negatively impact consumers and healthcare providers.” 

AHA also expressed concern that because UHG is the parent company of UnitedHealthcare, integrating the data sets of Optum and Change “would impact (and likely distort) decisions about patient care and claims processing and denials to the detriment of consumers and healthcare providers, and further increase UHG’s already massive market power.” 

During court proceedings, UHG’s lawyers asked representatives of several other health plans whether the combination with Change could dampen innovation in the health insurance industry. The defendants sought to use the testimony to counter DOJ’s argument that other insurers might be inhibited in implementing new ideas because UHG would have access to competitor data through Change.  

According to a summation in the September opinion, none of the health plan representatives said they expected an adverse impact on innovation.  

— Nick Hut, HFMA senior editor 

3. Physician compensation declines 2.4%, study says 

The average pay for physicians decreased 2.4% in 2022, according to the 2023 Physician Compensation Report [download required], which is based on a study by Doximity and Curative Talent.  

“It is clear physician salaries did not keep pace with the high rate of inflation in 2022, which reached a 40-year high of 9.1% in June, as measured by the Consumer Price Index,” wrote the study authors. “As a result, many doctors experienced a decline in real income, as inflation ran rampant.”  

In 2021, physicians saw an income increase of 3.8%, according to the report. 

Key findings 

Notable findings from the study include: 

Compensation across settings (see exhibit below). “Compensation varies widely by employment setting, with single specialty, solo practice, and multi-specialty groups ranking the highest in average annual compensation after controlling for specialty,” wrote the authors, noting compensation across all settings remained relatively flat or was slightly down.  

Compensation by metro area. In 2022, physicians in Oklahoma City saw the largest increase in compensation, with an annual growth rate of 6.3% and an average salary of $425,096. Of the top five metro areas by compensation, Oklahoma City ranked third, with Charlotte and St. Louis retaining their positions as the top two. San Jose ranked fourth, followed by Minneapolis. 

The lowest-ranked metro areas for compensation were Washington, D.C., Baltimore, Boston, San Antonio and Raleigh. 

Gender pay gap. “The gender pay gap among physicians also continues to be significant,” with female physicians earning nearly $110,000 less than male physicians, on average, “even when salaries were controlled for specialty, location, and years of experience,” wrote the authors.  

“This represents a 26% gender pay gap in 2022, compared to 28% in 2021,” they added. “While there appears to be slight movement in the right direction, physician pay parity continues to be a critical area in need of improvement.” 

Physician compensation growth by employment setting

Employment setting	Compensation growth	2022 average compensation
Single specialty group	-0.7%	$438,959
Solo practice	3.0%	$428,112
Multi-specialty group	-0.7%	$421,159
Health system / IDN / ACO	1.4%	$400,207
Hospital	-0.1%	$398,954
Industry / pharmaceutical	3.4%	$392,534
HMO	-0.8%	$387,393
Academic	-0.9%	$347,013
Government	1.8%	$269,189
Urgent care center / chain	-1.0%	$264,727

Source: Doximity/Curative Physician Compensation Report, used with permission

HFMA bonus content 

• Read the April issue of hfm, including the cover story “Meeting healthcare’s workforce challenges requires innovation — with a dose of humanity.” 
• Read “PatientRightsAdvocate.org misinterprets CMS rules in low estimate of hospital price transparency compliance,” by Shawn Stack, HFMA’s director of healthcare finance policy, perspectives and analysis. 
• Read “Court decision means cost sharing could be reinstated for some preventive healthcare services,” by Nick Hut, senior editor. 
• Read “Healthcare Blame Game: How news outlets mishandled a medical debt study” by Brad Dennison, HFMA’s chief content executive and executive editor of hfm magazine.