May 1, 2015 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
If bundled payment becomes more common in treatment of cancer, then anatomic pathologists need a strategy to demonstrate their clinical value to physicians and payers
MD Anderson Cancer Center and UnitedHealthcare (NYSE: UNH) announced a bundled payment agreement for the treatment of certain types of cancer. This development has implications for anatomic pathologist who provide cancer testing services to hospitals throughout the United States.
The new three-year pilot at MD Anderson’s Head and Neck Center in Houston, Texas, is the first use of a bundled payment model in a large, comprehensive cancer center. Officials say it is expected to lower costs while improving the quality of patient care and outcomes. As many as 150 patients with head and neck cancer who are enrolled in employer-sponsored UnitedHealthcare (UHC) plans will participate in the pilot.
“For the last five years, MD Anderson and its Institute for Cancer Care Innovation have been looking at how to best approach a single price for treating cancers. It is a complex question because cancer is a complex disease and each patient unique,” stated Thomas W. Feeley, M.D., Head of Anesthesiology and Critical Care, and Head of the Institute, in an MD Anderson news release. “Bundled pricing is something that patients and care providers want, and this is our first opportunity to better understand how we can manage costs without sacrificing quality care and patient outcomes.” (more…)
Aug 20, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
One reason is that the healthcare price websites operated by most states are inadequate, ‘poorly designed or poorly functioning’
Efforts to encourage price transparency at hospitals and other providers are making little progress. That’s one conclusion to be made from the second annual Report Card on State Price Transparency Laws, that gave a failing grade to 45 states.
This information is relevant because more consumers are now enrolled in high-deductible health plans. As a consequence, clinical laboratories and anatomic pathology groups must now handle requests from patients who want to know the cost of their medical laboratory testing in advance of service. As well, many of these consumers want to negotiate prices with their laboratory provider. (more…)
Jun 25, 2014 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Uncategorized
Maricopa Integrated Health System reports that price transparency pays off by reducing uncompensated care and increasing business
Arizona has a new law that requires hospitals, medical laboratories, diagnostic imaging facilities, ambulatory surgery centers, and urgent-care centers to publish the prices they charge self-pay and uninsured patients for the 50 most common inpatient and outpatient services. The law took effect on January 1, 2014.
News accounts report that just one hospital took steps to publish its prices earlier this year. Pathologists and clinical laboratory managers will find the experience of Maricopa Integrated Health System to be instructive, as hospital administrators there publicly state that this was the right thing to do for patients in their community. (more…)
Jun 16, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
Similar to Oscar Healthcare in New York, this California-based enterprise technology company offers services to make it easy for individuals to see providers’ prices, including medical laboratory test prices
Another company has entered the marketplace with their unorthodox business model to support health insurance programs. One cornerstone feature is a tool that enables both employers and beneficiaries to see the prices of different providers.
This young player in the health benefits marketplace is Castlight Health (NYSE: CSLT). Based in San Francisco, it was founded in 2008. One aspect of Castlight that pathologists and clinical laboratory managers may find particularly interesting is its price transparency tool. (more…)
