Mar 20, 2015 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
In California, a survey found significant inaccuracies in provider directories posted online—may trigger action by regulators to have insurers address this problem
Transparency in healthcare is an important trend. In recent years, much attention has been given to increasing the transparency of the prices charged to patients by hospitals, physicians, and medical laboratories. But now the transparency trend is about to drive change in the provider directories that health insurance plans make available to their beneficiaries and consumers.
When choosing a health plan, many people look for insurance that includes their own physician, or at least a doctor close to home. That is why an accurate and up-to-date provider list is essential to consumer choice and access.
But many health insurers fall short in this regard. California recently released chastising reports on two of its major health plans, Anthem Blue Cross and Blue Shield (ABCBS) (NYSE:WLP) and Blue Shield of California, (BSCA) for publishing inaccurate provider lists on the state’s California Covered insurance exchange. (more…)
Sep 24, 2014 | Laboratory Hiring & Human Resources, Laboratory News, Laboratory Operations, Laboratory Pathology
Growth in the number of employed physicians is contributing to heightened workplace tensions due to the cultural differences among the three generations now working together
What happens when Gen Y, Gen X, and Baby Boomer physicians are employees in the same hospital, clinic, or medical laboratory? There can be a clash of expectations, values, and goals that may cause tension in the workplace.
This happens when physicians, including pathologists, from different generations and different levels of experience levels come together as employees of hospitals and large medical groups, noted a recent story published by Modern Healthcare.
This is a result of the trend where more physicians are employed by hospitals today than ever before. For example, in 2006, just 16% of doctors worked for hospitals. However, by 2012 that figure had climbed to 20%. If physicians working in medical practices partially owned by hospitals are counted, then 26% of all physicians are employed by hospitals. (more…)
Jul 9, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Scheduled to launch in early 2015, the Health Care Cost Institute’s free online tool will give consumers access to data on provider prices and quality
It’s a significant sign of the times when three of the nation’s biggest health insurance companies agree to share data on healthcare prices and utilization specifically so that consumers can access this information. This will advance price transparency. It will also put more pressure on clinical laboratories to make it easy for consumers to see the prices of medical laboratory tests in advance of services.
This new price-transparency project includes Aetna (NYSE: ATE), UnitedHealthcare (NYSE: UNH), and Humana (NYSE: HUM). The three health insurers are partnering with the Health Care Cost Institute (HCCI), a nonprofit organization that maintains a database on healthcare cost and utilization.
The insurers will share healthcare price data. HCCI plans to provide the general public free, online access to this information, beginning in early 2015. (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…)
