Despite the Coronavirus Pandemic, Medicare Officials Continue Push for Price Transparency by Pressuring Hospitals to Disclose Rates Negotiated with Private Payers

Clinical laboratories are advised to continue developing methods for making prices for procedures available to the general public Even as an effective treatment for COVID-19 continues to elude federal healthcare agencies, Medicare officials are pressing ahead with efforts to bring about transparency in hospital healthcare pricing, including clinical laboratory procedures and prescription drugs costs. In FY 2021 Proposed Rule CMS-1735-P, titled, “Medicare Program; Hospital Inpatient Prospective...

Early Evidence from Medicare’s Bundled Payment Pilots Show Improved Quality at Reduced Cost of Care in Findings with Consequences for Medical Laboratories

Industry experts predict private payers will adopt bundled payment arrangements for both inpatient and outpatient procedures Early evidence indicates that Medicare’s bundled-payment pilot has helped participating providers improve the quality of care while better managing healthcare costs. Should more detailed findings confirm these outcomes, Medicare could decide to expand the range of clinical services it wants covered by a bundled-payment arrangement. As of the first of this year, in fact,...

New CMS Pilot Intends to Test Viability of a Universal Bundled-Payment Model for Inpatient Care

Nearly 500 healthcare organizations nationwide to participate in payment bundling for 48 Conditions Medicare’s largest bundled reimbursement project to date is now launching. Clinical laboratory executives and pathologists are watching for clues as to how these bundled payment arrangements will compensate the clinical laboratory testing done on behalf of patients whose care is covered by this latest Medicare initiative. The Centers for Medicare & Medicaid Services (CMS) will commence...

American Hospital Association Says Medicare’s Value-Based Purchasing Could Put Hospital Revenue at Risk

Where hospital margins to be squeezed, that would place hospital laboratories under greater budget constraints Hospitals are honing in on Medicare’s new value-based purchasing program quality metrics in an effort to improve patient care—and earn reimbursement rewards. Clinical laboratory managers and pathologists will want to track implementation of this program, because it is one further step forward in Medicare’s plan to move away from fee-for-service reimbursement. As part of its effort to...
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