Aug 23, 2013 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Management & Operations
Elements of Obamacare specifically support employer programs designed to improve the health of employees
Who would have believed that, after passage of the Affordable Care Act back in 2010, a fast-growing trend would be that of employers spending more money to develop employee wellness programs and offer medical clinics within corporate facilities? At a minimum, this development creates new opportunities for clinical laboratories to be direct providers of medical laboratory testing services to corporations.
Employee Wellness Programs Incorporate Medical Laboratory Testing
There is a simple reason why employers are jumping on the employee wellness bandwagon. Evidence demonstrates that incentivizing employees to live a healthier lifestyle can help reduce the cost of providing health insurance. It can also contribute to less absenteeism and increased employee productivity, both of which are important benefits to employers.
New data affirming this trend can be found in the 2013 Health Care Survey conducted annually by AON. AON is a global re-insurer that provides risk management services, insurance, and human resources solutions. About half of all U.S. employers now offer employee wellness programs, according to a recent study by Rand Corp., an independent think tank based in Santa Monica, California.
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Mar 30, 2012 | Laboratory Pathology
Now in its fifth year, Indiana’s CDHP now covers 90% of eligible state employees
Many pathologists and clinical laboratory managers are carefully watching for evidence that new healthcare delivery models can deliver improved patient outcomes at a lower cost. Now comes evidence that a consumer-directed health plan (CDHP) for Indiana state employees—that incentivizes consumers to manage their healthcare dollars more carefully—is saving money for both employees and the state.
According to a story in the Centre Daily Times (CDT), state officials in Indiana claim that the state’s CDHP has reduced the state’s overall health benefit costs and met with high subscriber satisfaction.
Governor Mitch Daniels and other Indiana officials claim that, since introducing the CDHP in 2006, the Hoosier state’s overall health benefit costs are down by more than 10%, with only 2% of subscribers switching back to a traditional plan, the CDT reporter wrote.
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Dec 9, 2011 | Laboratory News, Laboratory Pathology
Oregon adopts health engagement model for its state employees, as evidence of cost savings grows
Across the nation, pathologists and clinical laboratory managers will want to learn about a new model of healthcare reform. It is the “health engagement model” (HEM) and it is being rolled out by a number of health insurers.
Variations of the HEM model are gaining ground in states around the country because health insurers see HEMs as a way to reduce costs and improve quality of healthcare. One new HEM is taking root in the Pacific Northwest. The Oregon Public Employees’ Benefit Board (PEBB) recently adopted a new HEM for state employees, according to a story published by the Lund Report.
What may cause some medical laboratory managers to sit up and take notice is the fact that PEBB’s HEM is producing impressive participation numbers. “Thus far, 48% of members have enrolled for health plans,” stated Ingrid Norberg, Communications Coordinator at PEBB. “And 87% of participating members chose to participate in the health engagement model.”
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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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Sep 22, 2006 | Laboratory News, Laboratory Pathology
Enrollment in consumer-driven health plans or “CDHPs” has skyrocketed during the past 24 months. Now, UnitedHealth Group, the nation’s second-largest health insurance company, has announced membership growth increases of 75% in its CDHP and HRA (Health Reimbursement Account) offerings for the period between June 2005 and June 2006. Membership in UnitedHealth Group consumer-driven health plans has now surpassed 1.75 million people. Moreover, research suggests that even consumers working for employers that still offer more traditional health insurance options like PPOs and HMOs are choosing to enroll in CDHPs.
There is something else that is different about a CDHP-insured consumer: they tend to take a more proactive role in managing their healthcare. A UnitedHealth Group study suggests that individuals in consumer-driven health plans are more likely to be actively engaged in managing their health and making health care decisions, as compared to individuals with traditional health insurance. A joint study between Definity and UnitedHealth Group found that CDHP enrollees supplied with appropriate health care information have higher usage of preventative care services. They also less likely to pursue discretionary acute care services. As a result, they are hospitalized less and have fewer trips to the emergency room.
For clinical laboratories and anatomic pathology group practices, the growing number of consumers insured by a CDHP will be a sword that cuts both ways. On the negative side, laboratories will increasingly be billing consumers directly, often for the entire amount of the laboratory testing services performed. Experts expect that laboratories and pathology groups will see an increase in bad debt, as consumers either refuse to pay, or don’t have the money to pay, for up to 100% of their laboratory charges.
On the positive side, CDHP members will have increased freedom to choose their healthcare providers. Well-informed CDHP members may do research and actively select high-quality laboratories and acknowledged sub-specialist pathologists. The consumer will want a “world class” laboratory or pathologist to diagnose their case or provide a second opinion to their attending physician. Because of this fact, laboratories and pathologists who develop a public brand and increased awareness among consumers will likely have a competitive advantage.
Dark Daily predicts that consumer-driven health plans will have far-reaching consequences to the laboratory industry. Laboratories and pathology groups will need to learn and develop a service organization that can help CDHP members get answers to their questions, monitor the costs of tests and procedures, and research their health issues. Because it will be consumers choosing their providers, and not managed care companies as in past years, the overall trend of growing CDHP enrollment should benefit clinical laboratories and anatomic pathology group practices.
