Nov 19, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Pathologists and clinical laboratory managers will want to stay abreast of what emerging data is revealing about the broader impact of slowed growth in Medicare spending
Contrary to the predictions of some analysts, a recent study suggests that slowing Medicare price growth by lowering hospital reimbursements will slow hospital utilization and spending for all age groups. For pathologists and clinical laboratory managers, the study represents credible evidence that cuts in Medicare prices cause a measurable and linked decrease in hospital utilization for both the elderly and the non-elderly.
The Affordable Care Act of 2010 (ACA) permanently suppressed the rate of growth in Medicare reimbursements to hospitals and most other medical providers, according to a recent study by the Center for Studying Health System Change (HSC). In this study, the HSC sought to measure spillover effects of changes in Medicare inpatient hospital prices on patients under age 65. (more…)
Mar 26, 2012 | Coding, Billing, and Collections, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
Where hospital margins to be squeezed, that would place hospital laboratories under greater budget constraints
Hospitals are honing in on Medicare’s new value-based purchasing program quality metrics in an effort to improve patient care—and earn reimbursement rewards. Clinical laboratory managers and pathologists will want to track implementation of this program, because it is one further step forward in Medicare’s plan to move away from fee-for-service reimbursement.
As part of its effort to drive quality improvement at U.S. hospitals, the Centers for Medicare and Medicaid Services (CMS) issued final rules in 2011 for the first year of its Hospital Value-Based Purchasing Program (HVBP). The program is a pay-for-performance initiative that begins in fiscal 2013. Modern Healthcare reported on this story.
“[The HVBP structure] has been very eye-opening to a lot of people because we are not used to being compared that way,” observed Jeff Costello. He is Chief Financial Officer at Memorial Hospital & Health System in South Bend, Indiana. This 526-bed institution is on the latest Thomson Reuters’ 100 Top Hospitals list.
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Nov 9, 2011 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Some medical laboratory organizations risk coming up short on the deadline for implementation of 5010 standards
Less than eight weeks remain before the January 1, 2012, deadline for implementation of Form 5010. Every sector of the healthcare system—from government and private payers to hospitals, physicians, pathologists, and clinical laboratories—is involved in this important healthcare reform.
Many providers and payers are scrambling to meet the Health Insurance Portability and Accountability Act (HIPAA) version 5010 compliance deadline. This is the latest version of standards for the conversion of electronic health records (EHRs).
The Centers for Medicare and Medicaid Services (CMS) continues to maintain a hard line position regarding the deadline, according to an article in Modern Healthcare. “There is no wiggle room,” Denise Buenning, Director of the Administrative Simplification Group in CMS’ Office of E-Health Standards and Services, stated. “We’re holding fast to the date.”
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Jul 12, 2010 | Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
New Federal Mandate Will Make ACO-Based Provider Networks Responsible for Improving Quality and Cutting Costs
Pathologists and clinical laboratories are positioned to benefit from the provision in the Affordable Care Act of 2010 that is intended to reduce the cost of healthcare. It is the provision which authorizes the use of “accountable care organizations” (ACOs) and will be triggered in 2012.
Accountable care organizations are not yet a well-defined concept. ACOs are recognized to have some basic characteristics. First, an ACO is an integrated care network of providers with the ability to provide care to, and manage patients, across the continuum of care that should include different institutional settings, such as ambulatory care, inpatient hospital care, and even post-acute care.
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