Jun 18, 2014 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
In Massachusetts, a 1,000-physician group gets 70% of revenue from capitated payments, motivating the physicians to reduce unnecessary utilization of medical laboratory tests
Accumulating market evidence indicates that unnecessary utilization of medical laboratory tests—a problem bemoaned by pathologists for decades—may finally be addressed by an unlikely source: ordering physicians! Such a trend would have both positive and negative consequences for clinical laboratories throughout the United States.
What motivates physicians, on their own initiative, to reduce the unnecessary utilization of medical laboratory tests are changes in how they are paid. Many private health plans are reimbursing office-based physicians using global payment arrangements, such as capitation. (more…)
Sep 3, 2013 | Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
Commission issues 12 recommendations to enhance physician and patient satisfaction, while creating a financially sustainable healthcare system
How quickly will fee-for-service disappear as a primary source of reimbursement for clinical laboratories, pathologists, hospitals, and physicians? If the recommendation of one credible group of physicians has its way, fee-for-service reimbursement could disappear in as little as five years.
This recommendation was made by National Commission on Physician Payment Reform as part of a report it issued in May. In its press release, the commission issued a call “for eliminating stand-alone fee-for-service payment by the end of the decade.” The group urges a transition over five years to a blended payment system that will yield better results for both public and private payers, as well as patients.” (more…)
Nov 24, 2010 | Laboratory News, Laboratory Pathology
ACOs will change how clinical laboratories and pathology groups provide medical lab tests
Clinical laboratories and anatomic pathology groups will need to gear up to support accountable care organizations (ACO) in advance of Medicare’s “Shared Savings Program” launch in January 2012. But decades after the first ACOs opened their doors, some experts debate whether they’ve succeeded in their mission, which begs the question, are they a good idea at all?
According to the Integrated Healthcare Association (IHA) who funded the report “Accountable Care Organizations in California—Lessons for the National Debate on Delivery System Reform,” ACOs are intended to “promote higher quality and more efficient healthcare delivery in the United states.” But according to the report’s author, James Robinson, director of the Center for Health Technology at the University of California at Berkeley, current ACO structures might need to be redesigned if ACOs are to be ultimately successful.
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