Jun 25, 2014 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Uncategorized
Maricopa Integrated Health System reports that price transparency pays off by reducing uncompensated care and increasing business
Arizona has a new law that requires hospitals, medical laboratories, diagnostic imaging facilities, ambulatory surgery centers, and urgent-care centers to publish the prices they charge self-pay and uninsured patients for the 50 most common inpatient and outpatient services. The law took effect on January 1, 2014.
News accounts report that just one hospital took steps to publish its prices earlier this year. Pathologists and clinical laboratory managers will find the experience of Maricopa Integrated Health System to be instructive, as hospital administrators there publicly state that this was the right thing to do for patients in their community. (more…)
Jun 16, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
Similar to Oscar Healthcare in New York, this California-based enterprise technology company offers services to make it easy for individuals to see providers’ prices, including medical laboratory test prices
Another company has entered the marketplace with their unorthodox business model to support health insurance programs. One cornerstone feature is a tool that enables both employers and beneficiaries to see the prices of different providers.
This young player in the health benefits marketplace is Castlight Health (NYSE: CSLT). Based in San Francisco, it was founded in 2008. One aspect of Castlight that pathologists and clinical laboratory managers may find particularly interesting is its price transparency tool. (more…)
Jan 27, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Employers and health insurers want more consumers use healthcare cost estimator tools and pride when choosing a hospital, physician, or clinical laboratory
Having put millions of consumers into high-deductible health plans (HDHPs) as one way to control healthcare costs, both employers and health insurers are now challenged to help these same consumers do better at using price and quality factors when selecting providers.
One solution to this problem is to encourage physicians to play a greater role in helping their patients use price and quality when it is time to select a provider. Obviously, these decisions can involve which clinical laboratory or anatomic pathology practice a patient should select when he or she needs medical laboratory testing.
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Nov 4, 2013 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Management & Operations
With payouts riding on patient outcomes and value, ACO providers will welcome innovative services that clinical labs and pathologist could provide that improve patient outcomes
Both private health insurance companies and employers are betting on value-based insurance as the key to improving healthy behavior in patients. This will require more patient engagement in managing their chronic conditions. It will also include motivating patients to consider less expensive treatment options, particularly when the more expensive treatment path has limited benefits.
In this way, accountable care brings the patient into picture. It is a trend that opens the door for innovative clinical laboratories and anatomic pathology group practices to develop medical laboratory testing services that payers and employers recognize as contributing to improved patient outcomes—and for which they will adequately reimburse the laboratories providing these services.
Private Health Insurers Have More Flexibility in Design of Health Plans (more…)
Aug 23, 2013 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Management & Operations
Elements of Obamacare specifically support employer programs designed to improve the health of employees
Who would have believed that, after passage of the Affordable Care Act back in 2010, a fast-growing trend would be that of employers spending more money to develop employee wellness programs and offer medical clinics within corporate facilities? At a minimum, this development creates new opportunities for clinical laboratories to be direct providers of medical laboratory testing services to corporations.
Employee Wellness Programs Incorporate Medical Laboratory Testing
There is a simple reason why employers are jumping on the employee wellness bandwagon. Evidence demonstrates that incentivizing employees to live a healthier lifestyle can help reduce the cost of providing health insurance. It can also contribute to less absenteeism and increased employee productivity, both of which are important benefits to employers.
New data affirming this trend can be found in the 2013 Health Care Survey conducted annually by AON. AON is a global re-insurer that provides risk management services, insurance, and human resources solutions. About half of all U.S. employers now offer employee wellness programs, according to a recent study by Rand Corp., an independent think tank based in Santa Monica, California.
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