May 26, 2015 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Management & Operations
With patient care shifting to outpatient clinics and home-based medical care, clinical laboratory managers should beef up outreach lab testing services
Declining patient volume is shuttering hospitals across the United States as hospitals lose patients to ambulatory care centers and home-based medical care. This trend directly impacts the pathologists and medical technologists who work in the clinical laboratories of these hospitals.
Empty Beds Indicator of Failing Hospitals
Most pathologists are unaware that, between 2008 and 2013, nearly 130 community hospitals closed. That left 4,974 hospitals operating in the United States, according to American Hospital Association (AHA) 2015 Hospital Statistics, which are based on data from the 2013 AHA Annual Survey.
It is no surprise that below-average occupancy rates are a common denominator of most failed hospital, noted the Medicare Payment Advisory Commission (MedPAC). The 14 hospitals that closed in 2013 had an average occupancy rate of 34%. This is lower than the 48% average occupancy rate of the hospital nearest to the closing hospital, MedPAC stated in its March 2015 report to Congress. (more…)
Mar 6, 2015 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
After seeing a rise in the volume of clinical lab tests physicians order, managed care plans are develop a variety of strategies to manage utilization and costs
Health insurers are taking more aggressive actions to control the cost of clinical laboratory testing. For many years, clinical laboratories and pathology groups have been concerned about the strategies used by Medicare to control the utilization and costs of medical laboratory tests. Private health insurers usually follow the actions of Medicare, the nation’s largest health insurer. But today, managed care plans are developing their own lab-test-utilization strategies in addition to following those of Medicare.
Recently, Managed Care magazine explained many of the steps health insurers take to keep the costs of clinical laboratory tests under control. The cover story in the October issue of the magazine, “Health Plans Deploy New Systems To Control Use of Lab Tests,” outlined how health insurers Cigna, Group Health Cooperative, Priority Health, and UnitedHealthcare (UHC) are managing lab test utilization. (more…)
Feb 18, 2015 | Digital Pathology, Instruments & Equipment, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Evidence is emerging that medical laboratories using the ‘daily management’ approach can outperform other labs, even those using Lean methods
Clinical laboratories and anatomic pathology groups are information-rich environments. Yet, there is irony in the fact that—in response to financial pressures and incentives to improve the quality of medical laboratory testing services—most of the nation’s clinical labs cannot tap that rich vein of information to support performance improvement goals.
Those financial pressures have shrunk lab budgets and caused price cuts to medical laboratory test prices. These two factors are behind the trend of clinical labs and pathology groups buying middleware solutions that produce real-time data feeds on all aspects of lab operations, from phlebotomy and specimen transport, to accessioning, testing, reporting, client services monitoring, and billing/collections. (more…)
Feb 2, 2015 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, News From Dark Daily
Quest has not yet commented on the lawsuit, which was filed by three individuals who had clinical laboratory tests performed by the nation’s largest public lab company
In California last Thursday, three California residents filed a class action lawsuit charging Quest Diagnostics Incorporated (NYSE: DGX) with acquiring competitor medical labs, paying kickbacks to physicians, and developing exclusionary agreements with health insurers to monopolize the market for clinical laboratory testing in Northern California.
Filed in U.S. District Court for the Northern District of California, the complaint cites violations of the federal Sherman Act and the California Unfair Competition Law, Unfair Practices Act, and the Cartwright Act on behalf of California residents Christi Cruz of San Jose, Colleen Eastman of Hollister, and Carmen Mendez of, Milpitas. All three plaintiffs have used Quest laboratories and paid Quest Diagnostics Incorporated of Madison, New Jersey, for those testing services, the complaint says.
Lawsuit About Clinical Lab Testing Services Filed in Federal Court
The complaint was filed in the court’s San Francisco Division. In the court papers, lawyers for the three plaintiffs explain that injury to competition is manifest in three ways: above-competitive prices, inferior quality of testing, and reduction in choice among providers of routine diagnostic testing. “There is ample evidence that Quest has controlled prices in the relevant market in Northern California since at least 2011,” the complaint explains. (more…)
Sep 13, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Digital Pathology, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
Recent White Papers detail solutions for implementing new payment strategies for medical laboratories and pathology groups
Clinical diagnostic laboratories, pathology groups and healthcare institutions are carrying significant and potentially unsustainable levels of unreimbursed services. Although bad debt and uncompensated care in the healthcare industry are not new, they have been increasing at the same time that downward pressure is being applied to reimbursement.
Medical laboratories and pathology groups are also facing enormous levels of change in their clinical, regulatory and financial environments. As the Affordable Care Act is implemented, laboratories see downward pressure on reimbursement at both the federal and payer level, coupled with increased emphasis on efficiency and quality.
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