News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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MEDACorp Survey of Hospital Administrators Shows Inpatient Care is Decreasing; Could Change From Where Clinical Laboratories Receive Orders

As inpatient care declines, outpatient care expands, signaling a shift from where physician orders for medical laboratory tests originate

It’s a well-established fact that the year-over-year increase in the volume of outpatient procedures is consistently greater than 8%, while the annual growth in inpatient admissions is at or below 3%. Clinical laboratory managers and anatomic pathologists are aware of these facts.

MEDACorp, a strategic knowledge resource and subsidiary of Leerink Partners, a Boston-based investment bank that focuses on the healthcare industry, conducted a quarterly survey of hospital administrators from 47 hospitals in June of this year. The purpose was to evaluate healthcare utilization trends for different types of medical facilities.

According to the survey, the “ utilization trends for both [quarter-over-quarter] and [year-over-year] are decelerating across all four sites of service.” However, hospital administrators report the use of inpatient and other hospital services did not fare as well.

“The results are also modestly positive for facilities, with the slowing 0.7% increase in inpatient procedures (IP) utilization still higher than consensus of ~flat (sic) for the coverage group. Significant mix shift continues as IP mix is down and the outpatient procedure (OP) mix is up across all service lines, supporting our recent analyses of an accelerated push to ambulatory sites of service,” the survey noted.

The survey revealed:

  • Inpatient services increased by just 0.7% during the second quarter of 2018, down from 1% growth during the second quarter of 2017;
  • Ambulatory surgery center utilization grew by just 1.4% during the second quarter of 2018, down from 2.2% for the same quarter in 2017; and,
  • Emergency department utilization increased by 0.9% in the second quarter of 2018.

“It was even weaker than many of us expected,” Ana Gupte, PhD, Managing Director, Healthcare Services at Leerink, told Modern Healthcare. “It’s pretty clear there’s no volume rebound.” (Photo copyright: Leerink.)

Inpatient Top Surgeries Predicted to Keep Moving to Outpatient Settings

The Leerink survey found that orthopedic and cardiac procedures are leading the trend of shifting clinical procedures from inpatient to outpatient care. For example, heart surgeries were performed in outpatient settings 9% of the time over the past year and are expected to increase to 12% during the next year. Inpatient heart surgeries are expected to decrease 1% over the next year, moving from 82% to 81% of surgeries performed.

Inpatient hip procedures also are projected to drop from 77% to 75% over the course of the next year, while outpatient hip procedures are expected to increase from 17% to 19%. The survey respondents also expect other surgeries including urological, gynecological, spine and knee procedures to move to outpatient settings over the next year.

Forty-five percent of the respondents in the survey named baby boomers aging into Medicare as the most important driver of hospital utilization. Fifteen percent attributed the trend to the effects of the Affordable Care Act (ACA), and 13% cited the improving US economy as driving the use of outpatient medical facilities.

The graphic above, taken from the Leerink MEDACorp survey, illustrates a shift in healthcare procedures from inpatient to outpatient settings. Along with the surgical relocations are changes in reimbursements as well, which directly impacts clinical laboratories revenue streams and billing procedures. (Image copyright: Leerink.)

The survey respondents were from different regions and disparate population areas:

  • 49% of the surveyed facilities were located in metropolitan areas;
  • 40% were in suburban areas; and,
  • 11% were in rural areas.

In addition:

  • 32% were in the South;
  • 26% were in the Northeast;
  • 21% were in the Midwest; and,
  • 21% were in the West.

Most of the facilities used in the survey were community hospitals, which accounted for 62% of the environments. Thirty-two percent of the facilities were academic medical centers, while the remaining 6% were other types of facilities.

The majority of the respondents for the survey were C-suite executives. In hospital settings that would include the Chief Executive Officer (CEO), Chief Financial Officer (CFO), Chief Operating Officer (COO), and other Chief titles, and, of course, hospital administrators.

Clearly, this type of downward trend could negatively impact clinical laboratories, pathology groups, and other service lines in hospital networks. Fewer patients equal less revenue for hospitals, which could eventually lead to budget cuts. A responsible medical laboratory manager will be prepared for these possibilities.

—JP Schlingman

Related Information:

Hospital Execs Say Inpatient Volume Growth Isn’t Rebounding

Hospital Utilization Slows as Healthcare Moves to Cheaper Care Settings

2Q18 Hospital Util. Survey: Utilization Decelerating, Shift To OP/ ASC Continues

ASCs Beat Inpatient Setting for Quarter, Year-over-year Utilization Increases—6 Study Insights

10 Key Trends for ASCs and Outpatient Surgery in the Next 10 Years

Press Release: Preparing Health Network CEOs for Success with Precision Medicine: Early-Adopter Health Systems to Gather in Nashville September 12-13 to Share Advances in Oncology, Pharmacogenomics, Big Data

PRESS RELEASE

PRECISION MEDICINE INSTITUTE, LLC
21806 Briarcliff Dr.
Spicewood, Texas 78669
512-264-7103 o
512-264-0969 f

FOR IMMEDIATE RELEASE

Media Contact: Chris Garcia
Chris@darkreport.com

AUSTIN, Texas (August 14, 2018)—Precision Medicine is happening now at first-mover hospitals and health systems! September 12-13 in Nashville, experts from the nation’s most successful precision medicine clinical programs will gather to share their strategies and lessons learned. The goal of this conference is to provide hospital CEOs with the insights needed to initiate effective precision medicine programs in their own institutions.

Precision Medicine for Health Network CEOs: What You Need to Know about Genetic Testing, Precision Medicine, and Population Health Management” is a timely, two-day conference. It takes place at the Hutton Hotel in Nashville. This intimate meeting features nationally-respected, first-mover and early-adopter health networks sharing strategies, patient care successes, and outcomes from their precision medicine programs.

Keynote speaker is Jeffrey Balser, MD, the CEO of Vanderbilt University Medical Center. VUMC is internationally recognized for its pioneering efforts to bring precision medicine into daily clinical care. Attendees will gain essential insights into the early successes of precision medicine at VUMC, and will also learn about how the healthcare big database at Vanderbilt is being used to inform population health initiatives while also guiding the care that clinicians deliver daily to individual patients.

Among the twenty expert speakers sharing their respective experiences at bringing precision medicine, genetic medicine, and genetic testing into the daily care provided to their patients, will be:

  • Howard L. McLeod, PharmD, Medical Director, Personalized Medicine Institute, Moffitt Cancer Center, on Precision Medicine in Oncology/Cancer Care
  • Mark Van Oene, Chief Commercial Officer, Illumina, Inc., on Genetic Testing and Gene Sequencing’s Role in Precision Medicine
  • Julie A Johnson, PharmD, Dean, College of Pharmacy, University of Florida, on Precision Medicine in Pharmacogenomics
  • Josh Denny, MD, Vice President of Personalized Medicine at Vanderbilt University Medical Center, on Genetic and Molecular Data in Population Health

For more information and to register to attend “Precision Medicine for Health Network CEOs: What You Need to Know about Genetic Testing, Precision Medicine, and Population Health Management,” click here.  You may also contact Chris Garcia at 512-264-7103.

About Precision Medicine Institute, LLC

The Precision Medicine Institute has the unique mission of bringing together the executive leaders and physician leaders of the nation’s leading healthcare organizations, health networks, and corporations to understand the successes of first-movers and early-adopters as they bring precision medicine into clinical settings. The emphasis is on high-level knowledge of business strategies, clinical initiatives, and operational requirements needed to implement and sustain a clinically-effective and financially-sustainable precision medicine service that measurably improves patient care while helping hospitals avoid costs and generating ample reimbursement.

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A Lab Leader’s Guide To Pharmacogenomic Testing (PGx)

A Lab Leader’s Guide To Pharmacogenomic Testing (PGx)

The Dark Report is pleased to offer this FREE White Paper, providing an enlightening overview of pharmacogenomic testing and how PGx fits into current healthcare goals, a discussion of the obstacles healthcare providers, institutions and clinical diagnostic laboratories face in entering the pharmacogenomic testing market, and examples of how a cloud-based, Software-as-a-Service platform can help healthcare providers overcome those obstacles.

Harvard and Beth Israel Deaconess Researchers Use Machine Learning Software Plus Human Intelligence to Improve Accuracy and Speed of Cancer Diagnoses

Machine learning software may help pathologists make earlier and more accurate diagnoses

In Boston, two major academic centers are teaming up to apply big data and machine learning to the problem of diagnosing cancers earlier and with more accuracy. It is research that might have major implications for the anatomic pathology profession.

A collaborative effort between teams at Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School (HMS) has resulted in an innovation that could result in more accurate diagnoses in the pathology laboratory. The teams have been working on a machine learning software program that will eventually function as an artificial intelligence (AI) to improve the accuracy of diagnostics. They hope to someday build AI-powered computer systems that can accurately and quickly interpret pathology images. (more…)

Recently published White Paper reveals ways clinical laboratories and pathology groups can take advantage of growing opportunities in the area of pharmacogenomics

Increased understanding of the genetic basis of an individual’s response to drugs, including how and how quickly a drug is metabolized (pharmacodynamics and pharmacokinetics), has created rich opportunities for the establishment and expansion of PgX services.

Expertise such as this that is beyond traditional lab medicine is crucial to the future success
of your laboratory.

Pharmacodynamics and pharmacokinetics have opened the door to a progressively personalized approach to drug prescription. By identifying drugs most likely to benefit a patient, assessing the likely dose response, potentially avoiding adverse reactions, and reducing unnecessary use of drugs, pharmacogenomics testing (PgX) has helped optimize treatment and reduce costs associated with complications or inappropriate utilization.

As research demonstrating the clinical utility and associated health economics benefits of PgX has grown—along with the soaring trend toward value-based healthcare—PgX services are now on the path to becoming the standard of care. This demand for PgX presents a tremendous opportunity for clinical laboratories, many of which have already over the last few years successfully launched PgX services, and enjoyed robust growth. (more…)

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