Nov 2, 2016 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
The trend toward alternative payment systems continues as CMS announces the Comprehensive Primary Care Plus (CPC+) model
Efforts by Medicare officials to move providers away from fee-for-service payments and onto other models of reimbursement continue to move forward. This is one of several goals for a new primary care program that Medicare is about to launch in coming months.
Medical laboratories and pathology groups might feel an impact from this new program the Centers for Medicare and Medicaid Services (CMS) is testing. Announced in April, 2016, the program is called Comprehensive Primary Care Plus (CPC+). The CPC+ program is a five-year model that is designed to strengthen primary care, through establishing what are called “medical homes,” where patients experience more coordinated care. (more…)
Aug 1, 2016 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Clinical laboratories and pathology groups feel the impact of many of the Center’s demonstration projects that move healthcare toward value-based reimbursement
One perennial criticism of this nation’s healthcare system is that it is slow to innovate. Technologies and management principals widely adopted by many industries may take a decade or longer to gain acceptance by hospitals, physicians, and clinical laboratories.
To encourage faster adoption by useful technologies and innovations by providers, the Affordable Care Act (ACA) has a section that is not well known. This part of the law, passed in 2010, created the Center for Medicare & Medicaid Innovation.
The Innovation Center was included in the ACA legislation for the purpose of testing “innovative payment and service delivery models to reduce program expenditures … while preserving or enhancing the quality of care” for Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) beneficiaries.” (more…)
Mar 18, 2016 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Pathology, Laboratory Testing, Management & Operations
Medical laboratories will have to rethink billing practices when providing services to consumers receiving lump-sum payouts from their critical illness policy
Employers continue to look for ways to control the cost of health benefits for their employees. One emerging approach that will have financial consequences for clinical laboratories and anatomic pathology groups is a newer type of insurance that provides a lump-sum payout for some critical illnesses.
Policies with this lump-sum payment feature are sometimes referred to as critical illness coverage. Such policies typically pay a lump sum if someone is diagnosed with cancer, suffers a heart attack, stroke, kidney failure, or needs an organ transplant. Some plans also provide benefits for other major medical problems, such as loss of vision, paralysis, and Alzheimer’s disease. (more…)
Jan 13, 2016 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Testing, Management & Operations
Recently-announced partnerships want to use big data to improve patient outcomes and lower costs; clinical laboratory test data will have a major role in these efforts
In the race to use healthcare big data to improve patient outcomes, several companies are using acquisitions and joint ventures to beef up and gain access to bigger pools of data. Pathologists and clinical laboratory managers have an interest in this trend, because medical laboratory test data will be a large proportion of the information that resides in these huge healthcare databases.
For health systems that want to be players in the healthcare big data market, one strategy is to do a risk-sharing venture with third-party care-management companies. This allows the health systems to leverage their extensive amounts of patient data while benefiting from the expertise of their venture partners. (more…)
Dec 7, 2015 | Compliance, Legal, and Malpractice, Digital Pathology, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Testing
Pathologists and clinical laboratories could help reduce error rate through greater collaboration with providers
Expect the topic of diagnostic mistakes to get more media attention in coming years. That is consistent with the efforts of healthcare policymakers to improve patient safety while making it easier for consumers to access information about the quality and cost when selecting hospitals, physicians, and medical laboratories.
One opening salvo in this campaign is a new report from the Institute of Medicine (IOM) titled “Improving Diagnosis in Health Care.” It concludes that Americans will receive at least one wrong or late diagnosis in their lifetime. The rate of diagnostic errors is a patient-safety issue in which pathologists and clinical laboratories could play an important role in reducing.
Pathologists often know which physicians in their community routinely order inappropriate or wrong tests for patients. That is why pathologists could be instrumental in reducing diagnostic errors through better communication with providers to ensure doctors not only order the correct clinical laboratory tests, but also select the appropriate therapies based on test results. (more…)
