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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Studies Reveal Workers in HDHPs Pay Significantly Higher Annual Healthcare Costs than Employers and May Utilize Fewer Clinical Laboratory Tests

Consumers respond to high-deductible plans by using less healthcare services, which in turn leads to a decrease in doctor visits and clinical laboratory test orders

Are many Americans avoiding medical treatment because of the high-cost of their health plan deductibles? And if so, will such an underutilization of healthcare affect hospitals, independent medical practices such as pathology groups, and clinical laboratories?

Two separate studies: one a survey co-conducted by the Kaiser Family Foundation and the Healthcare Research and Educational Trust (KFF/HRET), and the other an analysis by the Health Care Cost Institute (HCCI), investigated the dynamics behind trends in the healthcare marketplace leading to these questions. (more…)

Kaiser Family Foundation Study Predicts Big Increases in Obamacare Premiums for 2017; However, Narrow Networks Often Exclude Clinical Laboratories and Other Providers

Accountable Care Act has reduced the number of uninsured, but has failed to deliver lower costs for most Americans or employers

More big increases are coming to Obamacare premiums during 2017. This is an important development and, depending on how the new Congress decides to address problems with the Affordable Care Act (ACA), the consequences can be either positive or negative for clinical laboratories and anatomic pathology groups.

Large increases in healthcare premiums can have a trickle-down effect on clinical laboratories and pathology groups since health insurers tend to reduce reimbursements to providers when they are in a financial squeeze. And while the November election puts the future of the ACA in doubt, a recently released Kaiser Family Foundation (KFF) study adds further evidence that Obamacare (colloquial for the ACA) has fallen short of its goal of reining in healthcare costs while simultaneously expanding healthcare coverage to millions of Americans.

The KFF study shows premiums in the ACA’s Health Insurance Marketplace will continue to increase in many regions in 2017. Researchers blame the higher price in part to the phasing out of the ACA’s reinsurance program and the unexpected losses many participating insurers have experienced. (more…)

More Small and Midsize Companies Opt to Self-Fund Workers’ Health Plans Despite Potential Risks: Might Clinical Labs Benefit from This Trend?

Self-insurance trend could push more businesses to independent and local clinical laboratories if self-insurers prefer to offer employees local access to testing services

Three years after the roll out of the Affordable Care Act’s (ACA’s) major provisions, more small and midsize companies may be opting to self-insure their employee health plans rather than face the coverage mandates and administrative costs imposed by Obamacare, a recent study found. It is uncertain how this trend will improve the access clinical laboratories and pathology groups have with these patients.

The Employee Benefit Research Institute (EBRI) study looked at trends in private sector self-insured health plans between 1996-2015, with a focus on 2013-2015, to assess whether the ACA might have affected those trends.

Researchers analyzed survey data from nearly 40,000 employers that participated in the US Census Bureau’s Medical Expenditure Panel Survey Insurance/Employer Component. They found that from 2013 to 2015: (more…)