Jul 9, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Scheduled to launch in early 2015, the Health Care Cost Institute’s free online tool will give consumers access to data on provider prices and quality
It’s a significant sign of the times when three of the nation’s biggest health insurance companies agree to share data on healthcare prices and utilization specifically so that consumers can access this information. This will advance price transparency. It will also put more pressure on clinical laboratories to make it easy for consumers to see the prices of medical laboratory tests in advance of services.
This new price-transparency project includes Aetna (NYSE: ATE), UnitedHealthcare (NYSE: UNH), and Humana (NYSE: HUM). The three health insurers are partnering with the Health Care Cost Institute (HCCI), a nonprofit organization that maintains a database on healthcare cost and utilization.
The insurers will share healthcare price data. HCCI plans to provide the general public free, online access to this information, beginning in early 2015. (more…)
May 23, 2014 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
For first time since launch of the Medicare program, CMS released data on Medicare payments to individual physicians
Once again, Medicare officials have stuck a blow for price transparency. On April 9, 2014, the Centers for Medicare and Medicaid Services (CMS) released data on total payments made to individual physicians for the year 2012. In several states, pathologists were identified as among the highest-paid physicians.
Release of this information generated stories by the national and local media. There was also plenty of criticism from a number of prominent national physician associations, including the American Medical Association. It was just last year when CMS released data on what 3,000 hospitals charged Medicare for the 100 most-frequently billed discharges. (more…)
Apr 28, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology
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…)
Apr 11, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Digital Pathology, Instruments & Equipment, Laboratory Management and Operations, Laboratory News, Uncategorized
Although most clinical laboratories and pathology groups do not use EHR systems, the OIG’s finding should alert them to possible problems with audit integrity of their clients’ EHRs
Electronic Health Record (EHR) systems were supposed to prevent fraud, but a recent report from one federal agency states that the fraud safeguards built into EHR systems are not in engaged by a majority of users.
Pathologists and clinical laboratory managers with the responsibility to maintain security of software systems used in their medical laboratories may be interested to read “Not All Recommended Fraud Safeguards Have Been Implemented in Hospital EHR Technology,” a report issued by the Health and Human Services’ (HHS) Office of the Inspector General (OIG). (more…)
Feb 12, 2014 | Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Market indicators support predictions of tougher financial times ahead for hospital-based clinical laboratories and pathology groups
New statistics for 2013 on employment in the healthcare and hospital sectors show the lowest rates of growth since 1990. This is a signal to pathologists and clinical laboratory executives that much belt-tightening is taking place by all types of providers.
For 2013, the healthcare sector added just 271,000 jobs. This was 2% less than the annual average since 1990, noted a recent report in Modern Healthcare. (more…)
