Jan 27, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Employers and health insurers want more consumers use healthcare cost estimator tools and pride when choosing a hospital, physician, or clinical laboratory
Having put millions of consumers into high-deductible health plans (HDHPs) as one way to control healthcare costs, both employers and health insurers are now challenged to help these same consumers do better at using price and quality factors when selecting providers.
One solution to this problem is to encourage physicians to play a greater role in helping their patients use price and quality when it is time to select a provider. Obviously, these decisions can involve which clinical laboratory or anatomic pathology practice a patient should select when he or she needs medical laboratory testing.
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Aug 26, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Managed Care Contracts & Payer Reimbursement, Management & Operations, News From Dark Daily
Study Finds Most State Websites Aimed at Transparency in Healthcare Pricing Inaccurate and Basically Useless in Helping Consumers Shop for Services
With growth in high-deductible health plans, healthcare is becoming increasingly consumer-driven. But shopping for healthcare services isn’t easy due to lack of available resources that enable consumers to compare price and quality, according to a recent study published in the Journal of the American Medical Association (JAMA).
Recently, the U.S. Department of Health and Human Services (HHS) revealed the arbitrary nature of hospital prices by publishing hospital-specific costs and outcomes data for 3,000 hospitals nationwide, according to a report published by Dark Daily. This step towards full transparency is aimed at helping consumers comparative shop for hospitals based on both quality and value.
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Jul 26, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations, Uncategorized
Clinical laboratories and pathology groups may want to review the prices they charge insured patients versus uninsured patients
There is a certain irony in the fact that hospitals and other medical providers typically charge patients without health insurance as much as three times what they charge Medicare or an insured patient. This situation is getting increased media scrutiny, which is one reason why clinical laboratories and pathology groups may want to review their own policies for charging patients without health insurance.
One good study on prices charged to self-pay patients was conducted by Gerard Anderson, Ph.D., a health economist at the Johns Hopkins Bloomberg School of Public Health. His study was funded by the Henry J. Kaiser Family Foundation and published in the May-June 2007 journal Health Affairs.
Anderson analyzed 2004 hospital billing data. He concluded that the gap between rates charged self-pay and insured patients has grown substantially since the mid-1980s. “In the 1950s, the uninsured and poor were charged the lowest prices for medical services. Today they pay the highest prices…,” wrote Anderson, noting that self-pay charges often reflect the hospital’s “chargemaster” prices–the top prices used to negotiate discounts with insurers. (more…)
Jun 17, 2009 | Laboratory News, Laboratory Pathology
Clinical laboratories can provide that missing education about CDHPs to patients
Even as enrollment in Consumer-Directed Health Plans (CDHPs) and Health Savings Accounts (HSAs) climbs steadily year after year, a new study reveals that most physicians are unprepared to help their patients understand and better use these forms of health insurance. This is a barrier to CDHP acceptance and an opportunity for clinical laboratories.
CDHPs—and their close cousins, HDHPs (high-deductible health plans_—are designed to shift more responsibility for healthcare decisions to patients. Many physicians, however, are unprepared to advise patients enrolled in CDHPs about cost-effective treatment options. This is the finding of a 2008 survey of 525 randomly selected doctors published in the American Journal of Managed Care . Nearly half, 43%, of doctors responding to the survey admitted knowing “a little” or “not at all” about CDHPs or HSAs. At least 33% of surveyed physicians said they are “somewhat” knowledgeable. Only 24% of physicians surveyed claimed “much” or “a great deal” of knowledge about CDHPs.
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Mar 30, 2009 | Laboratory News, Laboratory Pathology
Medical Group Management Association (MGMA) recently launched Project SwipeIT. This is an ambitious project to motivate the entire healthcare industry to adopt an electronic patient ID system by the end of 2009! The initiative asks insurers, providers, vendors and professional groups to commit to the deadline, as outlined by the Project SwipeIt portal on MGMA’s Website.
MGMA, a trade association of medical practice management professionals, estimates a nationwide electronic patient ID system could save providers $1 billion annually in unnecessary administrative costs and denied claims. Pathologists and laboratory administrators know that adoption of electronic patient ID would be a great benefit for clinical laboratories and pathology group practices.
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