Nov 9, 2016 | Compliance, Legal, and Malpractice, Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Laboratory Testing, Management & Operations
Many pathologists and other physicians are accelerating their retirement plans as they become familiar with how MACRA, MIPS, and ADM will change the way the Medicare Program pays for physician professional services
Will Medicare’s make-over to how it pays physicians accelerate the retirement of more doctors—including pathologists? That’s the question many experts are asking as the nation’s physicians learn more about the rule to implement the Medicare Access and CHIP Reauthorization Act (MACRA), with its Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) programs.
With the Center for Medicare and Medicaid Services (CMS) expected this fall to finalize changes in how physicians—including pathologists—get paid for Medicare services, it appears many physicians are considering retirement, rather than contend with Quality Payment Program (QPP) rules for a new value-based reimbursement system and other healthcare reforms.
The Physicians Foundation’s latest biennial survey, “2016 Survey of America’s Physicians: Practice Patterns and Perspectives,” indicated that 46.8% of physicians plan to “accelerate” their retirement plans due to changes taking place in healthcare. That number rises to 50% among doctors age 46 and older, and to 54.2% among physicians who own their own practices. (more…)
Jul 13, 2016 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
The amount of patient debt healthcare providers face depends on multiple, complex factors, including whether they engaged in Medicaid Expansion
Often the challenges facing hospitals and medical pathology laboratories are similar. So it is with patient debt. Blame that on two trends. One is the increase in the number of patients with high-deductible health plans. The other is the increase in the number of people enrolled via the Affordable Care Act (ACA) health insurance exchanges with similar high-deductible health plans.
These two factors are contributing to increased levels of bad debt that confront the nation’s hospitals, clinical laboratories, and anatomic pathology groups. However, in some states where Medicaid programs have been expanded, hospitals have reported declines in the level of patient bad debt.
When President Obama signed the Affordable Care Act into law in 2010, many people thought that fewer uninsured people would mean less bad debt for hospitals. Now, six years later, the reality is not so clear-cut.
Hospitals, clinical laboratories, and other entities within the healthcare system are seeing different levels of bad debt depending on what part of the country they are in, what kinds of policies they have enacted, and probably most importantly, whether or not the state in which they are located has expanded Medicaid. (more…)
Jun 15, 2016 | Compliance, Legal, and Malpractice, Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Testing
The decision means Walgreens will no longer offer Theranos blood-collection services at any of its stores, a move that is expected to cut Theranos’ income sharply because the lab testing company would no longer have a significant source of medical laboratory test volume
Walgreens Boots Alliance (NASDAQ:WBA) is ending its relationship with Theranos Inc. and closing all 40 Theranos Wellness Centers at its stores in Arizona, effective immediately, the national pharmacy chain store company announced on Sunday, June 12. It means that Theranos will no longer be able to collect medical laboratory specimens at pharmacies owned by Walgreens.
This move follows a decision by Walgreens in January that Theranos could no longer send clinical laboratory tests collected at Walgreen’s Wellness Centers to the Theranos lab in Newark, Calif. In the fall, the federal Centers for Medicare and Medicaid Services (CMS) cited the Newark lab as the source of serious deficiencies that risked patient harm, CMS said. (See Dark Daily, “CMS Notifies Theranos of CLIA Sanctions That Include Revoking Clinical Laboratory’s CLIA License and a Two-Year Ban on Holmes, Balwani, and Dhawan,” April 14, 2016.) (more…)
Jun 3, 2016 | Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Management & Operations
Medicare’s latest payment rules for joint replacement surgeries is another step forward on the path toward bundled payments and similar value-based reimbursement models
By now, most clinical laboratory managers and pathologists know about an ambitious new Medicare program that essentially brings a value-based reimbursement model to joint replacement surgeries. The program has already commenced in a number of regional markets across the United States.
This new program was instituted by the U.S. Department of Health & Human Services (HHS). It is mandatory program and reimburses providers for hip and knee replacements using a reimbursement model that further ties Medicare payments to quality or value metrics. This program was launched in 67 metropolitan areas.
Called the Comprehensive Care for Joint Replacement (CJR) model, it establishes a 90-day episode of care from the date of the replacement procedure. Hospitals remain accountable for all charges related to recovery and rehabilitation within this window.
(more…)
Jan 6, 2016 | Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Testing, Management & Operations
Tableau Software, IBM, Apple and others are building a future where analysis of clinical data guides personalized medicine, fuels research, and helps reduce healthcare costs
Use of big data in healthcare is poised to become a big business. That’s because new players in data analytics have begun to help providers and accountable care organizations (ACOs) effectively use data to improve their business operations, personalize care for patients, and/or discover new medical insights.
Because more than 70% of a typical patient’s permanent medical record consists of clinical laboratory laboratory test data, pathologists and medical laboratory scientists have a stake in the growth of big-data analytics, which are a core component in healthcare’s journey toward personalized medicine. (more…)
