The largest health plans began seeing medical spending rise earlier this year and are expecting costs for the current flu season to be higher than usual.
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Recovery act rewards also would assist physicians in tackling chronic diseases and medical school debt.
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Another roughly $5 billion remains to be distributed by the end of 2010.
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Physicians worry that the ruling could hurt patient care if certain medical research is monopolized.
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Forty of the 600 directly employed doctors will take home 5% to 10% less.
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