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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CPC+ Continues CMS’ Efforts to Establish Medical Homes

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…)

Two Lab Leaders Present Different Ways to Help Physicians Get Greater Value from Clinical Pathology Laboratory Testing

In response to healthcare’s transformation, a pathologist and a lab CEO describe two powerful ways that medical laboratories can collaborate with physicians, patients, health systems, and health insurers to deliver more value

DATELINE: Phoenix, Arizona—It may be appropriate that, with the pace of change heating up in both healthcare and the clinical laboratory industry, it was here in the hot Sonoran Desert that more than 500 medical laboratory professionals gathered last week for the annual Sunquest User Group Conference (SUG) hosted by Sunquest Information Systems. (more…)

More Workplace Tension in Hospitals and Clinics as Three Generations of Physicians—Baby Boomer, Gen X, and Gen Y—Try to Get Along

Growth in the number of employed physicians is contributing to heightened workplace tensions due to the cultural differences among the three generations now working together

What happens when Gen Y, Gen X, and Baby Boomer physicians are employees in the same hospital, clinic, or medical laboratory? There can be a clash of expectations, values, and goals that may cause tension in the workplace.

This happens when physicians, including pathologists, from different generations and different levels of experience levels come together as employees of hospitals and large medical groups, noted a recent story published by Modern Healthcare.

This is a result of the trend where more physicians are employed by hospitals today than ever before. For example, in 2006, just 16% of doctors worked for hospitals. However, by 2012 that figure had climbed to 20%. If physicians working in medical practices partially owned by hospitals are counted, then 26% of all physicians are employed by hospitals. (more…)

Early Evidence from Medicare’s Bundled Payment Pilots Show Improved Quality at Reduced Cost of Care in Findings with Consequences for Medical Laboratories

Industry experts predict private payers will adopt bundled payment arrangements for both inpatient and outpatient procedures

Early evidence indicates that Medicare’s bundled-payment pilot has helped participating providers improve the quality of care while better managing healthcare costs. Should more detailed findings confirm these outcomes, Medicare could decide to expand the range of clinical services it wants covered by a bundled-payment arrangement.

As of the first of this year, in fact, Medicare officials expanded the bundled-payment program associated with the hospital Outpatient Prospective Payment System (OPPS) by requiring certain clinical laboratory, anatomic pathology, and other clinical services be reimbursed as part of the bundled payment initiative. This action was taken independent of the bundled-payment pilot program. (more…)

Many Hospitals and Doctors Not Happy with Federal Rules for Accountable Care Organizations (ACOs)

Major healthcare stakeholders speaking out with criticisms of federal ACO rules

It may be that the Obama administration bit off more than it can chew with its first release of proposed rules for Accountable Care Organizations (ACO). Lining up in opposition to these rules is an impressive list of the nation’s most respected healthcare organizations. Included are Mayo Clinic, Geisinger Health System, Cleveland Clinic, and Intermountain Healthcare.

Pathologists and clinical laboratory managers will undoubtedly recognize the significance of this opposition. Health officials within the Obama administration have regularly stated that ACOs should be organized to deliver the same type of tightly integrated healthcare that is the standard at Mayo Clinic, Geisinger Health, Cleveland Clinic, and Intermountain Health. Thus, it is not auspicious for the Obama administration that these four institutions are making public statements that, under the ACO rules as now written, they are not inclined to participate.
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