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…)
Feb 22, 2016 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Uncategorized
Provider-health plan integration in Wisconsin may serve as model for hospitals and health systems nationwide as they establish their own health insurance plans
One interesting new trend in healthcare is the growth in the number of provider-owned health insurance plans. This is a development that could be auspicious for local clinical laboratories and anatomic pathology groups because most provider-owned health plans want local labs in their provider networks. This includes contracting with their own hospital labs.
In fact, experts at the Deloitte Center for Health Solutions believe that provider-sponsored health plans are “a potentially disruptive industry innovator.” If this assessment plays out, provider-owned health insurance plans may make big inroads on the market share currently held by insurance industry giants such as UnitedHealthcare, Anthem, Aetna and others. (more…)
Jan 27, 2016 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Syracuse, New York, aims to position itself as the healthcare destination of choice for Ontarians right across the border who are weary of waiting for free healthcare from their provincial health service
There is a new twist in medical tourism! United States hospitals are advertising to Canadians who are frustrated by increasingly long waiting times for elective medical procedures from their national health service. U.S. providers are hoping to lure them across the border for quicker access to care.
Until recently, U.S. hospitals were not motivated to attract Canadian patients as a way to generate new admissions. However, years of sustained cuts to prices paid to U.S. hospitals by health insurers have made it economically attractive for U.S. hospitals to advertise to Canadian patients just across the border. The medical laboratories of American hospitals serving medical tourists benefit from this source of patients.
Number of Canadians Coming to U.S. for Medical Care Each Year Growing
While Canadians get most of their medical care for free through a nationwide, single-payer system administered by each province, thousands of Canadians come to the U.S. each year seeking medical care. In 2014, an estimated 52,513 Canadians received non-emergency medical treatment outside Canada. The largest number of patients leaving the country for healthcare are from the Province of Ontario and total 26,252, according to the Fraser Institute, a Canadian research organization. The number of Canadians seeking medical care outside the country’s borders was up 26% from a year earlier, the study showed. (more…)
Jan 25, 2016 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Testing, Management & Operations
Clarification comes just a week after one CMS official had discussed the end of Meaningful Use at a conference in San Francisco
Talk about mixed messages! Is the federal Meaningful Use (MU) program about to end? Or is it going to continue and evolve in significant new ways?
Alert pathologists and clinical laboratory executives may have picked up on the conflicting statements about the future plans for Meaningful Use that have been made in recent weeks by certain officials from the Centers for Medicare and Medicaid Services (CMS).
Because thousands of hospitals and hundreds of thousands of physicians have made substantial capital investments in electronic health records to qualify for federal incentives, any major change to the Meaningful Use requirements will have broad consequences.
Medical laboratories have a big stake in this issue as well, since they must invest substantial money into creating the interfaces needed to connect their labs’ laboratory information systems (LIS) to the EHRs of client hospitals and physicians. (more…)
Jan 20, 2016 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Pathology, Laboratory Testing
State governor declares ‘state of emergency’ and asks central government for aid to get healthcare facilities reopened in city that will host 2016 Summer Olympics
As U.S. healthcare officials look to contain the spiraling cost of care in this country, government leaders in Brazil are facing an unprecedented healthcare crisis that has caused cash-strapped public hospitals in Rio de Janeiro to close their doors or limit services due to lack of funds.
No News Coverage about Brazil’s Medical Laboratories
Clinical laboratory executives and pathologists should take note of this unfolding story. It may be without precedent that public hospitals in the capital city of one of the world’s faster-growing economies have had to cease medical services because there is no money to pay physicians and staff and buy the necessary medical supplies.
Luiz Fernando Pezão, the current State Governor of Rio de Janeiro, on Dec. 23, 2015, declared a “state of emergency” after as many as 15 outpatient clinics closed and hospitals began limiting their admissions to those with life-threatening conditions. (more…)
