New AHA Report Finds Hospital Outpatient Revenue Nearing Inpatient Revenue, While CMS Proposes Paying Less for In-hospital Healthcare Services

Clinical laboratories that service both settings could be impacted as new CMS proposed rule attempts to align Medicare’s payment policies for outpatient and in-patient settings Hospital outpatient revenue is catching up to inpatient revenue, according to data released from the American Hospital Association (AHA). This increase is part of a growing trend to reduce healthcare costs by treating patients outside of hospital settings. It’s a trend that is supported by the White House and Medicare...

Sonic Healthcare Uses Test Data to Create Shared Savings Opportunities for Clinical Laboratory and Providers

Sonic’s data-driven approach to population health management, based on helping clinicians intervene with patients to control healthcare costs, increases the lab’s revenue Sonic Healthcare USA is using clinical laboratory test data to help its client providers improve population health. This effort also has allowed the Austin, Texas-based lab company to share in the savings one provider client received from the Medicare Shared Savings Program. Using integrated financial and clinical analytics,...

Reimbursement Expert Advises Pathologists and Hospitals to Ensure Part A Contracts Are Balanced and Reflect Both Fair Market Value and Commercial Reasonableness

When negotiating an effective Part A contract for professional pathology services, the best approach is to structure an agreement that is fair and reasonable to both the hospital and the pathologist. That’s the advice given by Robert Tessier, Senior Reimbursement Consultant, HBP Services, Inc. in an interview with Dark Daily. In his position with the Woodbridge, Conn.-based management consulting firm, Tessier advises hospitals on their contracts with pathology groups (HBP stands for...

Analytics Help Clinical Laboratories Minimize Risk and Remain Innovative as Esoteric and Molecular Testing Markets Grow

Data-driven proof supports decision-making that optimizes efficiency and boosts bottom lines in the face of shrinking margins and increased competition Molecular and esoteric testing developers continue to make advanced assays and diagnostic technologies available to medical laboratories. However, some laboratory senior management and stakeholders may be reluctant to invest in them even though the market for such testing is poised for significant growth. That’s because lab shareholders might...

New CMS Final Rule Makes Clinical Laboratory Test/Procedure Pricing Listed on Hospital Chargemasters Available to Public

Experts are skeptical of the value of public price lists based on hospital chargemasters due to complexity and poor reflection of actual costs In another big step toward helping consumers view prices of medical procedures when selecting providers, the Centers for Medicare and Medicaid Services (CMS) passed the IPPS/LTCH PPS final rule, which requires hospitals to post a full list of hospital pricing information on their websites starting January 1, 2019. Clinical laboratories, anatomic...

FDA Authorizes 23andMe to Report Results of Direct-to-Consumer Pharmacogenetics Test to Customers without a Prescription, Bypassing Doctors and Clinical Laboratories

FDA cautions patients to not use data gained from the DTC test to make healthcare decisions on their own Clinical laboratories continue to be impacted by the growing direct-to-consumer (DTC) testing market, as more walk-in lab customers order at-home tests. Now, the US Food and Drug Administration (FDA) has authorized a DTC test company to provide results of a pharmacogenetic (PGx) test to customers without needing a doctor’s order. This is the first genetic test of its kind to receive such...