Innovative medical laboratories shared their successes in improving lab test utilization that included physician engagement and close monitoring of key metrics
DATELINE: ORLANDO, FLORIDA—One big challenge facing medical laboratories and anatomic pathology groups in the United States today is the need to transition from a transaction-based business model (increasing specimen volume leads to increasing revenue) to a value-based business model (helping providers improve their use of clinical laboratory tests in ways that measurably improve patient outcomes while controlling or reducing the cost of care.)
Two trends reinforce the need for clinical laboratories to craft strategies to develop new ways to add value to lab testing services.
One trend is the move by Medicare and private health insurers to shift reimbursement for providers away from fee-for-service and toward bundled reimbursement and budgeted reimbursement.
The second trend is the emergence of integrated clinical care organizations. The most visible of these are accountable care organizations (ACO) and patient-centered medical homes (PCMH). What these care delivery organizations have in common is that they require hospitals, physicians, clinical laboratories, imaging centers, nursing homes and other types of providers to work together more effectively so that patients receive healthcare in a seamless fashion because there is a continuum: primary care to specialty care to acute care and back again. (more…)
Pathologists and clinical laboratory managers could find opportunity to add value as providers learn to use big data to improve patient outcomes and lower costs
Early adopter accountable care organizations (ACOs) are establishing data warehouses. This is a first step in collecting and analyzing healthcare big data. The move toward integrated care makes big data critical to an ACO’s success. Pathologists and clinical laboratory managers will want to follow the healthcare big data trend because laboratory test results will be a major component of that data.
The Goal of Healthcare Big Data
The goal for healthcare big data is twofold: 1) develop the ability to aggregate a vast amount of data from wide-ranging sources, and 2) use that data in real time to improve care and lower costs, a recent story published in Modern Healthcare (MH) reported. New performance-based reimbursement models mean that big data analytics will be essential for ACOs to succeed going forward. (more…)
Clinical laboratories and pathology groups are deploying customer relationship management tools as a way to deliver more value to physicians and other providers
Healthcare’s accelerating shift away from fee-for-service payment and toward value-based reimbursement presents new challenges to clinical laboratories and pathology groups. These new payment models motivate providers to seek strategic partners who can deliver added value.
To succeed in this paradigm, clinical laboratories must differentiate themselves. This will require effective management of client relationships. Labs will soon need to do much more than simply process medical test orders and send lab results back to referring physicians. In fact, early-adopter lab organizations are accomplishing these goals by using client relationship management (CRM) tools.
To serve these lab organizations, vendors are bringing customized CRM tools to market. Unlike the generic customer relationship management products of past years, these next generation CRM products are tailored to meet the complex needs of healthcare organizations. CRM systems that are customized to the needs of clinical laboratories and pathology groups are now available.
Nine of the 10 largest medical groups are located on the East and West coasts
When it comes to the list of the 20 largest physicians groups in the United States, Kaiser Permanente is at the top. With 7,000 physicians, Permanente Medical Group in Northern California is the nation’s largest. Number two is Southern California Permanente Medical Group, based in Pasadena, California. At number 20 is the University of Indiana School of Medicine with 1,481 physicians.
This list was prepared by the Medical Group Management Association (MGMA) and published in Modern Healthcare . One interesting fact is that all but one of the 10 largest medical practices are located on the east or west coast. Overall, six of the top 20 medical groups are located in the Midwest, one in Texas, and the rest in coastal cities.
There are 51, 280 physicians practicing in the nation’s 20 largest medical groups. This represents about 6.4% of the 800,000 physicians licensed in the United States – P. Kirk
20 Largest Medical Groups:
|RANK – GROUP
|# OF DOCTORS
|1. Permanente Medical Group
|2. Southern California Permanente Medical Group
|3. Bellevue Hospital Center
|4. University of Medicine & Dentistry of Newark
|5. Albert Einstein College of Medicine of Yeshiva Univ.
|6. University of Pittsburgh Medical Center
|7. Johns Hopkins University
|8. Columbia University Medical Center
|9. David Geffen School of Medicine at UCLA
|10. Mayo Clinic
|11. University of Washington Medicine
|12. Northeastern Ohio Univ. Colleges of Med & Pharmacy
|13. University of Michigan Health System
|14. Massachusetts General Hospital
|15. University of Pennsylvania Medicine
|16. Baylor College of Medicine
|17. University of Illinois Medical Center at Chicago
|18. Northwestern Memorial Hospital
|19. Winthrop University Hospital
|20. Indiana University School of Medicine
|Total all physicians from all groups:
|Source: MGMA, Englewood, Colorado
Largest medical group practices
Is Integration in Large Medical Groups Associated With Quality? (PDF)
Benefits of and Barriers to Large Medical Group Practice in the United States (PDF)