Jul 30, 2012 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Uncategorized
Clinical labs and pathology groups will want to be prepared for cash-paying patients who demand discounted prices for medical laboratory tests
For decades, it has typically been difficult for a patient to get, in advance of treatment, a specific price from a healthcare provider. This has been true, whether the provider was a hospital, an office-based physician, or an ancillary clinical service. This lack of “price transparency” makes it difficult for patients to shop for healthcare providers—including clinical laboratories—based on the same combination of quality and price that they use to make other important purchases in their lives.
Recently, the Los Angeles Times looked into the arcane world of healthcare pricing. Its reporter was astonished to discover that, in California, it was possible for a cash-paying patient to be charged a price by a hospital that was just 16% of the “patient list price.” Furthermore, this cash price was less than half of what that hospital had negotiated with at least one major health plan! (more…)
Apr 13, 2012 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Hiring & Human Resources, Laboratory Pathology, Management & Operations
Hospital laboratories may find GPOs respond by contracting with more vendors to expand choices of products
Major changes are unfolding in the world of group purchasing organizations (GPOs). As healthcare’s transformation shifts the clinical and financial emphasis of hospitals, health systems, and other providers, these institutions are changing their relationship with GPOs.
In turn, such trends mean changes in the GPO contracts available to hospital laboratories. In the United States, every hospital and health system is typically a member of at least two GPOs. Thus, the clinical laboratories of these hospitals must also participate in the national contracting programs operated by the GPOs.
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Aug 24, 2011 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
“Bundled Payments for Care Improvement Initiative” will be voluntary for hospitals, physicians, and other providers, including medical laboratories
Yesterday, Medicare officials took the first steps to implement a program for bundled Medicare payments by issuing documents which describe how this program would work. At least two of the four models for bundled reimbursement will include clinical pathology laboratory tests as part of the bundled care arrangement.
Clinical laboratory managers and pathologists will want to pay close attention to this development. The Centers for Medicare and Medicaid Services (CMS) titled this new effort the “Bundled Payments for Care Improvement Initiative.” It is a voluntary program. Only those providers who submit proposals and bids which are accepted will be paid through this program. The goal is to encourage different providers to collaborate on the care of a patient. Each of the four models for bundled healthcare has a slightly different payment arrangement.
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Jul 8, 2011 | Laboratory News, Laboratory Pathology
Meanwhile, financial pressures mean smaller budgets for hospital laboratories
When it comes to multi-hospital health systems, the biggest are getting bigger. But many health systems are not covering their costs. These were the findings from a recent annual survey of health systems by Modern Healthcare magazine. It confirms what pathologists and clinical laboratory directors see in many regional markets.
As we wrote in Dark Daily on June 29, three factors are driving this growth trend: federal healthcare reform, mandated spending on health information technology (HIT), and the economic contraction from 2007 to 2009 that pushed smaller hospitals to merge with larger health systems. This is the analysis reported by Modern Healthcare. (See Dark Daily, Modern Healthcare’sTop 10 Largest Health System Rankings also Reveal Nation’s Largest Hospital-Based Laboratories, June 29, 2011.)
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Aug 14, 2009 | Laboratory News, Laboratory Pathology
Clinical laboratories can play a role in two of these ten cost-cutting opportunities
Everyone in healthcare expects significant across-the-board cuts to reimbursement as healthcare reform moves forward. High profile targets for cost-cutting are imaging technologies and physician preference items (PPIs), which include expensive supplies and implant products, including stents, wires, pacemakers, and knee/hip replacement prosthetics.
Hospitals and health systems, in recognition of this major shift in national health policy, are scrambling to stay ahead of these economic and regulatory pressures. It is causing them to closely scrutinize operational costs and implement cost-cutting measures.
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