May 13, 2016 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
Faster than expected transition from fee-for-service healthcare should grab attention of clinical laboratories and anatomic pathology groups who face financial unknowns under new payment systems
Clinical laboratory executives should take note of a key financial fact. The transition from fee-for-service healthcare to value-based reimbursement is occurring at a faster clip than the Department of Health and Human Services (HHS) anticipated last year when federal officials announced a plan to tie 30% of traditional Medicare spending to alternative payments models by the end of 2016.
That means the transition away from fee-for-service payment for medical laboratory tests and other healthcare services is moving ahead of schedule. As evidence, HHS recently announced it reached the 30% target at the start of 2016, nearly a year ahead of the schedule laid out when the Obama Administration outlined a plan to reward healthcare providers based on quality of care rather than the volume of services they provide.
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Mar 2, 2016 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Testing, Management & Operations
Robert L. Michel, Editor-in-Chief of The Dark Report, was recognized with the W.A.D. Anderson award for his contributions to the profession of pathology and laboratory medicine
DATELINE—Miami Beach, Florida: What better time to be here on Florida’s trendy South Beach than February, when winter’s chilly winds blow across much of the United States. That’s one reason why a record crowd of pathologists assembled at the Fountainebleau Hotel to attend the 40th annual “Review and Recent Practical Advances in Pathology” that took place here on February 15-19.
The conference addressed such hot topics in anatomic pathology as new predictive markers and prognostic markers in surgical pathology and recent developments in the field of cytology. This meeting is produced by the Pathology Department at the University of Miami’s Leonard M. Miller School of Medicine. It is a Monday-through-Friday event, designed to allow attendees ample lecture time with some opportunities to get outdoors and enjoy the weather and the beaches. (more…)
Feb 15, 2016 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Blue Cross Blue Shield of North Carolina expands a website that allows consumers to check the prices charged by physicians; Clinical labs are watching the price transparency trend
Once again, a major health insurer has raised the stakes on transparency of the prices charged by physicians, hospitals, clinical laboratories, and anatomic pathology groups. Blue Cross Blue Shield of North Carolina (BCBSNC) recently expanded a website for its members that lists what the insurer pays to different providers for various clinical services.
The database is searchable. Members have been able to access it since January of 2015. The website lists 1,200 non-emergency procedures, along with the average price that BCBS pays for each one.
Physicians Also Want Price Transparency
Consumers want more transparency of the prices charged by providers. But they are not the only group pushing for it. In a surprising twist, physicians in North Carolina were supportive of having their prices posted on a public website. (more…)
Jan 13, 2016 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Testing, Management & Operations
Recently-announced partnerships want to use big data to improve patient outcomes and lower costs; clinical laboratory test data will have a major role in these efforts
In the race to use healthcare big data to improve patient outcomes, several companies are using acquisitions and joint ventures to beef up and gain access to bigger pools of data. Pathologists and clinical laboratory managers have an interest in this trend, because medical laboratory test data will be a large proportion of the information that resides in these huge healthcare databases.
For health systems that want to be players in the healthcare big data market, one strategy is to do a risk-sharing venture with third-party care-management companies. This allows the health systems to leverage their extensive amounts of patient data while benefiting from the expertise of their venture partners. (more…)
Sep 28, 2015 | Coding, Billing, and Collections, Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory Pathology, Laboratory Testing
As national health insurers push more risk to hospital systems and medical groups, many hospital administrators become more interested in establishing their own health insurance companies
New modes of provider reimbursement—such as bundled payments and budgeted payments—are motivating hospitals and health systems to reconsider their existing relationships with health insurers. Hospital administrators want to control the dollars they save by improving patient care, instead of allowing insurance companies to capture that money.
To accomplish these goals, more and more hospitals and health systems across the country are making one of three moves:
• Funding their own health plans;
• Partnering with health insurance companies; or,
• Buying health insurance companies.
As this trend gathers momentum, it will put the medical laboratories of hospitals in a much better position to regain access to patients. It can be expected that hospital administrators will include their own clinical laboratories and anatomic pathology providers in their own health insurance provider networks. (more…)
