Essential to protect pathology reimbursement with skilled management
Despite a slow economy, new technology continues to flood into anatomic pathology. These two contradictory forces make it essential for pathologist business leaders and their practice administrators to respond appropriately to preserve reimbursement and maximize the compensation of pathologists in the group.
Dollars are not flowing to labs as easily as before, and money left on the table can be the difference between a lab’s success and failure. Dark Daily recently caught up with Lance Beard, administrator at HistoPath, the largest provider of anatomic pathology services in South Texas, to talk about the challenges laboratories are facing in the current landscape.
“At this moment, the biggest issue is the sputtering economy,” Beard said. “That is really the headline. Efforts to reform healthcare add to the uncertainly. Combine that with the ever fewer dollars paid for pathology services and I believe pathology groups must do one of two things: go back to basics or move to the future.
“The strategy of going back to the basics recognizes that, because the dollars are leaner, and pending legislation would remove more dollars from pathology, it is essential for the pathology group to take care of the basics,” explained Beard. “One good example is revenue cycle management (RCM). In the past when the dollars were easier, pathology labs didn’t have to put significant effort into managing the revenue cycle. The dollars flowed in rather easily. Tight-fisted payers have changed that. Now, with dollars scarce, every pathology group needs to make the effort to analyze key elements of their revenue cycle to identify ways to collect more of the reimbursement to which they are legally due.”
Another strategy for pathology groups is to beef up the sales effort. “Pathology labs are closely watching the source of their case referrals,” noted Beard. “There is a renewed interest in sales and marketing. As competition gets fiercer, more pathologists are taking time to think about the dynamics of a creating and managing a sales force. They want to know how large should it be, what duties are appropriate, and how much should be paid.
Beard next tackled the subject of health insurance plans. “Payers are feeling these pressures too,” he noted. “That’s causing them to do things they didn’t do in the past. Payers are reading the fine print in contracts, changing reimbursement, and not paying for things for which they paid in the past. Unfortunately, too many pathology groups are experiencing these problems in some of our managed care contracts.”
Along with the strategy of addressing the basics of pathology practice management, Beard considers it important that pathology groups exercise foresight to consider the technological leaps that are reshaping the pathology profession.
“The future is four things,” he advised:
- “First, using Lean methods to make your lab’s workflow better and more efficient. That increases the quality of the product you produce.
- “Second is technology and automation, such as automation in histology and digital imaging.
- “Third is online access to data, so doctors can see pathology reports, often in real time.
- “Fourth, many pathology groups are using enhanced information technology to create ‘Dashboards’ or ’Flash Reports’ that allow pathologists and their staff to manage the business in great detail. The future is going to be online access to the data and not a monthly report on paper.”
For pathologists and pathology practice administrators interested in advancing their knowledge and skills in pathology management, Beard will be leading a session at the upcoming “Pathology Management Boot Camp” . This will take place on November 12-13, 2009, at the Hilton Skirvin in Oklahma City, Oklahoma. This is the second year that the American Pathology Foundation has organized this special event. Visit the Boot Camp’s sign up page.
“At the end of the day, a pathology laboratory is like a sports team,” concluded Beard. “Before the World Series, both the Yankees and Phillies went back to the basics and worked on the fundamentals of hitting and fielding. Running a pathology laboratory is no different. Regardless of how much experience any pathologists or practice administrator, it is always worthwhile to go back and study the basics. And, in these uncertain economic times, emphasizing the basics takes on increased importance!”