Oct 31, 2016 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Uncategorized
Recent studies indicate that high readmission rates often may be due to patient demographics, giving clinical laboratories an opportunity to use lab test results in ways that minimize the need for specific patients to be readmitted
Medicare’s efforts to reduce hospital readmission rates have left most hospitals facing reductions in Medicare payments. However, a recent ranking of hospitals by the Modern Healthcare Data Center indicates that influences other than inferior care—such as patient demographics—can affect 30-day readmission rates.
These findings are noteworthy for pathologists and clinical laboratory managers operating medical laboratories in hospitals and health systems. That’s because readmission rates impact a hospital’s budget. Thus, less revenue can cause hospital administrators to reduce spending for clinical laboratory and anatomic pathology services. (more…)
Jun 27, 2016 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Operations, Laboratory Pathology, Laboratory Testing
Pathologists and clinical laboratory managers can expect that CMS will accelerate the shift from fee-for-service reimbursements to bundled payment models
It is still not widely recognized among clinical laboratory managers and pathologists that Medicare program officials are serious about moving forward to replace fee-for-service provider payment with value-based payment methods. In fact, many medical lab professionals may not have heard the news from earlier this year that one-third of Medicare payments are now value-based.
It is important for all clinical lab executives to be aware of the press release issued by the federal Department of Health and Human Services on January 26, 2015. It was the first time that the Medicare program had published goals for moving away from fee-for-service that were tied into specific dates. (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.
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