Changes in Healthcare Costs During the Obama Administration: Government Spending

A look at the numbers resulting from healthcare reform and the Affordable Care Act across the eight years of the Obama Administration

Over the eight years of the Obama administration, there has been significant and unprecedented legislation intended to address the well-known problems with health insurance and high healthcare costs in this country. There has also been plenty of bluster, criticism, and commentary about the consequences of the Affordable Care Act (ACA), which became law in 2010.

With a new administration and Congress about to take office, many media outlets and experts are looking back over the past eight years to assess what actually happened to the US healthcare system during this time. From independent medical laboratories and pathology groups, to large-scale health systems, reform and the impact of the Obama Administration has changed—and continues to change—the way America approaches healthcare.

Over President Obama’s two terms, there were significant changes to payment structures, insurance markets, and communications between healthcare service providers. In turn, these initiatives have spurred innovation and drastically altered the way many healthcare and diagnostics providers operate. (more…)

Anthem and Aurora Healthcare Create Joint Venture; Trends for Health Systems Entering Insurance Markets Continue to Grow

As health systems accept increased risk under healthcare reform, partnerships and provider insurance plans may also lead to greater rewards for hospitals and doctors

Even as pathologists, clinical laboratories, and other medical service providers adapt to value-based care initiatives and bundled payment plans, health systems are looking for ways to optimize both quality of care and treatment costs. In some cases this is the reason behind new joint ventures between provider and payer organizations.

Once such joint venture involves Anthem Blue Cross and Blue Shield and Aurora Healthcare. It was announced in an April press release.

The two partners created a newly licensed insurer called the Wisconsin Collaborative Insurance Company (WCIC). With both Anthem and Aurora Healthcare investing $5-million in the new insurance company, they will split equally any profits and losses derived from their new commercial health plan—Well Priority.

The plan includes services with 15 Aurora Healthcare hospitals as well as choice providers throughout the state. The first commercial plan will be available to fully insured and self-insured employers, with service starting January 1, 2017. (more…)

Paper Microfluidic Devices Offer New Potential for Affordable Point-of-Care Tests for Use in Developing Countries That Have Few Clinical Laboratories

Paper-based devices could perform complex, multistep diagnostic tests at a fraction of the cost of traditional medical laboratory analysis

Many research teams are racing to create paper-based devices for medical laboratory tests. Their primary goal is develop a cheap, fast, reliable way to perform diagnostic testing in third world settings, where modern clinical laboratories are few and far between. One development team is working to combine lab-on-a-chip technologies with the low cost of paper-based platforms.

Meanwhile, over the past decade, point-of-care testing (POCT) has revolutionized diagnosis and treatment options for a myriad of conditions. In developing regions or remote areas, low-cost POCT improves accessibility to vital tests for infectious diseases, such as HIV, Malaria, and Ebola, as well as acute medical conditions, such as sepsis.

In the past eight years, Dark Daily has reported many times on the emergence of new POCT devices. From lactic acid screening to the lab-in-a-needle, which is used for detecting liver toxicity, the ability to produce a quick and accurate diagnosis without intensive clinical laboratory testing is growing.

However, one area where many POCT devices face challenges is in surviving extended environmental exposure. This does not pose an issue in major research hospitals or health systems. However, the consequences can be severe when considering the often harsh, resource-limited conditions of developing countries—one area in which POCT stands to offer the greatest value. (more…)

Creating Added Value from Clinical Pathology Laboratory Testing Produced Improved Outcomes at University of Mississippi Medical Center and Broward Health

Innovative medical laboratories shared their successes in improving lab test utilization that included physician engagement and close monitoring of key metrics

DATELINE: ORLANDO, FLORIDA—One big challenge facing medical laboratories  and anatomic pathology groups in the United States today is the need to transition from a transaction-based business model (increasing specimen volume leads to increasing revenue) to a value-based business model (helping providers improve their use of clinical laboratory tests in ways that measurably improve patient outcomes while controlling or reducing the cost of care.)

Two trends reinforce the need for clinical laboratories to craft strategies to develop new ways to add value to lab testing services.

One trend is the move by Medicare and private health insurers to shift reimbursement for providers away from fee-for-service  and toward bundled reimbursement and budgeted reimbursement.

The second trend is the emergence of integrated clinical care organizations. The most visible of these are accountable care organizations (ACO) and patient-centered medical homes (PCMH). What these care delivery organizations have in common is that they require hospitals, physicians, clinical laboratories, imaging centers, nursing homes and other types of providers to work together more effectively so that patients receive healthcare in a seamless fashion because there is a continuum: primary care to specialty care to acute care and back again. (more…)

More Workplace Tension in Hospitals and Clinics as Three Generations of Physicians—Baby Boomer, Gen X, and Gen Y—Try to Get Along

Growth in the number of employed physicians is contributing to heightened workplace tensions due to the cultural differences among the three generations now working together

What happens when Gen Y, Gen X, and Baby Boomer physicians are employees in the same hospital, clinic, or medical laboratory? There can be a clash of expectations, values, and goals that may cause tension in the workplace.

This happens when physicians, including pathologists, from different generations and different levels of experience levels come together as employees of hospitals and large medical groups, noted a recent story published by Modern Healthcare.

This is a result of the trend where more physicians are employed by hospitals today than ever before. For example, in 2006, just 16% of doctors worked for hospitals. However, by 2012 that figure had climbed to 20%. If physicians working in medical practices partially owned by hospitals are counted, then 26% of all physicians are employed by hospitals. (more…)