Healthcare Consumers Opting for Lowest Cost Plans on Obamacare Exchanges, Putting Additional Pressures on Marketplace Insurers

Sep 1, 2017 | Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Laboratory Testing, Managed Care Contracts & Payer Reimbursement

Price transparency trend is altering decision-making in many aspects of healthcare and providing lesson for medical laboratory executives Medical laboratory executives are well aware that price transparency is an increasingly powerful trend in healthcare. Now, as consumers increasingly opt for lower-cost options when making healthcare decisions, the 2010 Affordable Care Act (ACA) provides a notable example of this new reality, with consumers making cost, not choice, their top concern when...

Kaiser Family Foundation Study Predicts Big Increases in Obamacare Premiums for 2017; However, Narrow Networks Often Exclude Clinical Laboratories and Other Providers

Dec 16, 2016 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Testing

Accountable Care Act has reduced the number of uninsured, but has failed to deliver lower costs for most Americans or employers More big increases are coming to Obamacare premiums during 2017. This is an important development and, depending on how the new Congress decides to address problems with the Affordable Care Act (ACA), the consequences can be either positive or negative for clinical laboratories and anatomic pathology groups. Large increases in healthcare premiums can have a...

Higher Enrollment in Medicare Advantage Plans Means that More Local Clinical Laboratories and Pathology Groups Lose Access to these Patients

Aug 25, 2014 | Compliance, Legal, and Malpractice, Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Pathology

Health insurers offering Medicare Advantage plans are narrowing their networks and favoring the national clinical lab companies over local medical labs and pathology groups Enrollment in Medicare Advantage health plans is booming. This development is not auspicious for local medical laboratories, hospital lab outreach programs, and anatomic pathology groups because the private health insurers operating these plans typically prefer to contract with national lab companies while narrowing their...

Fee-for-Service Payment to Phase Out in Five Years? That’s the Recommendation of National Commission on Physician Payment Reform

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...

Government Wants Seniors with Medigap Policies to Pay More Out-of-Pocket, but Health Insurance Association Gives ‘Thumbs Down’ to the Idea

Feb 15, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology

Raising the out-of-pocket costs for Medicare beneficiaries with Medigap  policies not likely to be favorable for medical laboratories If federal officials have their way, Medicare beneficiaries with comprehensive Medigap polices are likely to pay a greater share of the cost of their medical care. The goal is to reduce use of unnecessary medical services and save Medicare money. For clinical laboratories and anatomic pathology groups, this may not be a welcome development. That’s because any...