News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Higher Deductibles and Co-Insurance Costs Squeezing Healthcare Consumers’ Wallets; A Reasons for Clinical Labs to Make Lab Test Prices Easy to See

Two new studies show patients are being increasingly burdened with a greater share of healthcare costs, which requires providers, including medical labs, to collect more money from patients at time of service

Although wage increases remain stagnant, consumers now pay a steadily increasing share of their healthcare costs. That’s because of rising deductibles, co-insurance, and other out-of-pocket costs. Not only will this cost-sharing trend continue to stretch patients’ budgets, it also will apply more pressure on clinical laboratories and pathology groups to increase price transparency for patients.

A recent study at the University of Michigan (UM), published in the Journal of the American Medical Association (JAMA), highlighted the growth in out-of-pocket insurance costs for hospitalized patients. For the average consumer with private health insurance, costs rose from $738 in 2009 to $1,013 in 2013—a 37% increase. During that same 4-year period, overall healthcare spending grew at 2.9% per year and health insurance premiums went up 5.1% annually.

Two types of health insurance plan charges were responsible for the biggest change in out-of-pocket spending: deductibles and co-insurance. During the same period, deductibles rose by 86%! Co-insurance costs increased 33% over the same period. Co-payments (a flat fee) were used in fewer hospitalizations. (more…)

Innovative California NPR Project Takes on Healthcare Pricing Transparency

NPR stations in San Francisco and Los Angeles crowdsourced healthcare cost data from listeners to reveal arbitrary pricing of medical services

Over the past two years, Dark Daily has published a number of stories dealing with price transparency, or lack of it, most of which involved government agencies or nonprofits concerned about the high cost of healthcare services. This latest effort to shine a light on healthcare pricing, however, comes from National Public Radio (NPR).

San Francisco’s NPR station, KQED, initiated PriceCheck, an innovative project designed to reveal just how arbitrary medical pricing is in California, in June 2014. KQED partnered with Los Angeles’ NPR station, KPCC, and ClearHealthCosts.com, a New York City start-up that publishes a national list of low to high charges for common healthcare services, to crowdsource healthcare cost data.

The two NPR stations appealed to listeners to share the charges they paid for four medical services: mammograms, lower-back MRIs, IUDs, and diabetes testing. Hundreds of people responded to share prices they paid for these services, and thousands of people looked up prices on ClearHealthCosts.com. (more…)

Study Shows Too Many Electronic Alerts Cause 30% of Primary Care Physicians to Overlook Essential Clinical Laboratory Test Results

Missed results in EHRs were related to information overload, electronic handoffs from one provider to another, and perceptions of poor usability of the EHR

Physicians often overlook important clinical laboratory test results when they get too many alerts in a day. This was one of several findings from a study designed to see how physicians responded to alerts delivered through an electronic health record system (EHR).

These findings will not surprise most pathologists and medical laboratory managers. Daily and weekly, they see how frequently “out of normal” test results can be reported to a referring physician. (more…)

Study at Johns Hopkins Shows Price Transparency Works: Physicians Order Fewer Clinical Pathology Laboratory Tests When They Know the Cost

Giving physicians Information on the price of medical laboratory tests at the time of order decreased overall use of such tests by about 9%, researchers said. 

Physicians order fewer clinical laboratory tests when they know how much they cost, according to a recent study at the Johns Hopkins University School of Medicine.Those findings are good news for hospital-based pathologists  who must often respond to physicians who order expensive esoteric tests that are inappropriate for the patient’s condition or lack documentation as to clinical utility.

The study results show another dimension to the power of transparent pricing in healthcare because it demonstrates that physicians are willing to take cost into consideration when deciding what clinical laboratory tests they should order. Some experts believe that publishing price information on the costs of care empowers consumers to shop for the best price, thus helping to reduce the overall cost of healthcare.

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