Mar 3, 2017 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
Medical laboratory and pathology groups could benefit from trend by receiving payments for testing services from secondary payer rather than directly from patient
As high-deductible health plans (HDHPs) become the norm for more Americans, gap insurance is being touted as an innovative way to protect consumers from crippling healthcare costs. This added insurance protection is proving attractive to a growing number of patients with HDHPs.
Use of gap plans by more patients also could benefit clinical laboratories and pathology groups. That’s because patients with HDHPs who would normally be required to pay 100% of their lab testing charges until their annual deductible is met, would be covered for these costs because of their gap insurance. In these situations, labs would have a secondary insurer to bill until the annual deductible was met. (more…)
Jun 17, 2013 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Management & Operations
As ACO movement gathers momentum, hospitals and health systems see opportunities in providing health insurance
Hospitals and health systems are getting back into the health insurance business. Not only is this seen as an opportunity created by the development of accountable-care organizations (ACOs), but it may help the clinical laboratories of these same hospitals that serve office-based physicians in their communities.
This trend is another result of the Obamacare legislation. Some hospital systems are seizing an opportunity to expand their roles and grow revenue by once again getting into the health insurance business. Some experts believe this trend is likely to create more competition among insurers.
It may also accelerate the shift away from fee-for-service reimbursement to a global or bundled payment structure. As this occurs, medical laboratories will need to develop services that offer greater value to physicians and patients. (more…)
