News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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As Medical Laboratory Test Utilization Grows, Health Insurers Develop Programs to Manage Rising Costs

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…)

Physicians and Pathologists at Atrius Health Collaborate to Reduce Unnecessary Clinical Laboratory Test Orders and End Up Saving $1 Million Annually

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…)

50 Years of Service in Clinical Laboratories Celebrating the Careers of Two Medical Technologists

In Connecticut and California, there are two medical technologists who have each put in 50 years on the job in their respective hospital laboratories

On opposite coasts of the United States, two medical technologists (MT) were each recognized by local newspapers for more than 50 years of service in clinical laboratories in their respective communities! As members of what is often called the “Greatest Generation”, these two long-serving med techs have much to teach the three younger generations now working in the nation’s medical laboratories.

For the last 51 years, Sandra Allard has worked in the laboratory at Waterbury Hospital, in Waterbury, Connecticut. The 69-year-old typically works in the blood bank, but pulls one night a week in chemistry, according to an article published by the Republican-American, a newspaper in Waterbury. Jeffrey Pinco, M.D., the Medical Director of the hospital laboratory, described Allard as an employee who cares about the hospital’s patients and brings old-fashioned values to her job. (more…)

Chi Solutions Regains Independence as a Clinical Laboratory Consulting Firm

Latest example of a larger company spinning off its laboratory consulting businesses

For the second time in recent years, a large organization has spun off its clinical laboratory consulting business. As of April 1, 2010, Chi Solutions, Inc., of Ann Arbor, Michigan, once again became an independent company.

Carilion Clinic of Roanoke, Virginia, sold Chi Solutions to Kathleen Murphy, Ph.D., and Earl Buck. It was April, 2005 when Carilion Clinic originally acquired the Laboratory Solutions Group of Park City Solutions and named it Chi Solutions. Murphy and Buck have been the principal consultants at Chi Solutions.


Comparative Effectiveness: It’s Here! It’s Now! And It’s Funded to the Tune of $1.1 Billion!

Effort will identify which clinical procedures actually benefit patients—and are cost-effective

“Comparative effectiveness research (CER)” is likely to be one method that healthcare reformers use to establish reimbursement for different medical technologies and treatments. This will apply equally to clinical laboratory testing and pathology professional services as well as other medical procedures.

There is a compelling reason why comparative effectiveness is likely to happen on this turn of the healthcare reform wheel. Congress put teeth into the comparative effectiveness movement earlier this year when it provided $1.1 billion to support the effort in the American Recovery and Reinvestment Act of 2009.