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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More Providers and Payers Use Bundled Pricing to Serve Patients with High Deductibles in a Trend That Has Financial Implications for Clinical Laboratories

This phenomenon is a response to the tens of millions of patients who now have high deductibles that must be met before their insurance kicks in

There’s a new wrinkle on bundled pricing for medical laboratory tests and other healthcare services. Some providers and payers are creating bundled pricing options specifically for the tens of millions of patients now covered by high-deductible health plans (HDHPs).

Patients covered by HDHPs are responsible to pay thousands of dollars out of pocket before their health insurance kicks in. Thus, it should not surprise clinical laboratory professionals that providers and health insurers are collaborating to created bundled pricing (AKA packaged pricing) options that cater to self-pay patients.

Bundling is a method in which healthcare services are grouped together for one pre-determined price. It is intended to decrease costs while providing patients with increased access to high-quality care. Clinical labs and pathology groups will need to negotiate with the organizers of these bundled medical services in order to get adequate payment for their testing services.

Bundled service options are gaining in popularity because more Americans are paying out-of-pocket for medical care. Some people have no health insurance coverage at all. Meanwhile, tens of millions of Americans are enrolled in high-deductible health plans. These patients are typically responsible for paying thousands of dollars in out-of-pocket expenses before their health insurance begins paying for medical services. With so many people seeking more economical choices for their healthcare needs, providers, hospitals, and health insurers are exploring the options bundled pricing offers. (more…)

Mayo Clinic Researchers Determine That Use of High Definition Optical Technology Enables Physicians to Identify Precancerous Polyps Immediately

Authors of the published study wrote that use of HD optical technology during colonoscopies gives patients a faster answer and may eliminate the need to refer biopsies to pathologists

High definition optical technology is reaching the point where gastroenterologists are able to identify pre-cancerous polyps with 96% accuracy during colonoscopies, according to a recent study conducted at the Mayo Clinic. Pathologists will want to pay close attention to the published findings of this study. That’s because GI biopsies represent a significant proportion of specimens referred to anatomic pathologists.

Researchers at Mayo Clinic  worked with high-definition (HD) imaging systems, such as the Olympus Evis Exera II 180 and the Evis Exera III CV-190. The study was published in the June 24, 2014 issue of Gastrointestinal Endoscopy. (more…)

New Clinical Laboratory Test Exposes Cancer Cells with Ultra Violet Light: Improves Accuracy of Current Cancer Assays, Say Researchers

New technology accurately distinguishes between cancerous cells and healthy cells. Will it give pathologists a “universal” assay for cancer diagnosis?

In England, a university team has developed a new technology for detecting circulating cancer cells in blood. Their method uses ultraviolet light and the results are so promising that efforts are now underway to develop this method into a clinical laboratory test.

That is why pathologists and medical laboratory professionals may soon have a new tool in their arsenal: one that significantly aids physicians and medical laboratories in the diagnosis of cancer. (more…)

At the University of Michigan, Research Study Indicates how Composition of Gut Microbiome May Serve as Complementary, Noninvasive Screening Tool for Colon Cancer

If validated by additional research, microbiologists, pathologists, and medical laboratory professionals might soon find analysis of the human microbiome to be a useful marker in screening for colon cancer

Microbiologists may play a greater role in the early detection of colorectal cancer, if the findings of a research study at the University of Michigan (UMich) are confirmed with additional clinical studies.

Combining gut microbiome analysis with traditional risk factors for colorectal cancer—such as body mass index (BMI), age, and race—significantly improved the ability of pathologists to distinguish healthy people from those with precancerous or cancerous lesions, wrote researchers from the UMich in a scholarly paper published in the November 2014 issue in Cancer Prevention Research.

Research findings indicate that gut microbiomes may be a major factor in development of colorectal cancer. However, more research is required to determine if this microbial community has the potential to be clinically useful as screening tool for early-stage disease. (more…)

Health Insurers Encourage Physicians to Help Patients Use Cost and Quality Data to Select Providers, Including Medical Laboratories

Employers and health insurers want more consumers use healthcare cost estimator tools and pride when choosing a hospital, physician, or clinical laboratory

Having put millions of consumers into high-deductible health plans (HDHPs) as one way to control healthcare costs, both employers and health insurers are now challenged to help these same consumers do better at using price and quality factors when selecting providers.

One solution to this problem is to encourage physicians to play a greater role in helping their patients use price and quality when it is time to select a provider. Obviously, these decisions can involve which clinical laboratory or anatomic pathology practice a patient should select when he or she needs medical laboratory testing.

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