Innovative Programs by Geisinger Health and Kaiser Permanente Are Moving Providers in Unexplored Directions in Support of Proactive Clinical Care

These initiatives are a call-to-action for clinical laboratories to contribute their expertise in support of wellness programs Two of the largest healthcare systems in America are moving in non-traditional directions to proactively address certain healthcare populations. Most recently, Kaiser Permanente announced it will be investing millions of dollars to tackle homelessness and the disease outbreaks associated with it. The health system is even investing in a housing complex in Oakland,...

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...

Recently published White Paper explores effective new ways for clinical labs and pathology groups to reverse the trend of uncollected revenue in an era of higher patient requirements and reimbursement pressures

As a result of the drive toward consumer-driven healthcare, and because of rising health insurance deductibles, patients are increasingly becoming the new payers. Efficient patient access management is now viewed as critical to reversing the resulting trend of uncompensated care, and to meeting the lab’s revenue cycle objectives. As patients take on more risk and assume more of their own healthcare costs, and as registration errors, authorization, and medical necessity continue to contribute...

Results of Harvard Study into Medicare Costs Offers Opportunities for Clinical Laboratories

Harvard’s study of high-cost Medicare patients offers insights into how medical laboratories can help improve early diagnosis, optimize therapies, and monitor chronic disease Clinical laboratories and anatomic pathology groups supporting Medicare patients understand that a small portion of high-cost patients make up the majority of Medicare spending. Between extended treatment, comorbidities, and the complex nature of disease therapies, chronic illnesses have a major impact on healthcare...

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...