Mar 25, 2016 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory Operations, Laboratory Pathology, Laboratory Testing
Along with its assessment of the rate of errors in diagnosis, the IOM has a plan to improve, but will doctors accept the IOM’s advice, or continue business as usual?
Diagnostic errors in the American healthcare system is a problem that is now on the radar screen of policymakers at the Institute of Medicine (IOM). Pathologists and clinical laboratory professionals will welcome this development, because recommendations from the IOM carry weight with Congress.
Thus, should the IOM develop specific actions items intended to reduce medical errors, not only are these suggestions likely to involve more effective use of medical laboratory tests by physicians, but there is a strong probability that Congress might eventually write these recommendations into future healthcare legislation.
The Institute of Medicine is a division of the National Academies of Sciences, Engineering, and Medicine. The IOM recently convened a committee that released a list of recommendations to address the problem of diagnostic errors in medicine. Those recommendations, however, are running up against ingrained mindsets and overconfidence on the part of physicians who are reluctant to include decision-support technology in the diagnostic process. (more…)
Feb 24, 2016 | Compliance, Legal, and Malpractice, Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
As reimbursement models shift, physician practice management companies (PPMCs) offer increased value and appeal for hospital-based physicians (HBPs)
Are physician practice management companies (PPMCs)—a hot trend during the 1990s—poised to make a comeback in this decade? Whether this healthcare business model can gain traction during the 2010s remains to be seen, but, of all physician specialties, pathologists are likely to be among the most skeptical, just as they were during the 1994-2000 heyday of PPMCs.
In the mid-1990s, such physician practice management companies as MedPartners, Phycor, and others raised billions of dollar to invest in both independent physician practices and hospital-based physician (HBP) groups. But not even 10 years later, competition for viable practices drove prices above sustainable levels and many PPMCs closed shop. (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…)
Feb 15, 2016 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Blue Cross Blue Shield of North Carolina expands a website that allows consumers to check the prices charged by physicians; Clinical labs are watching the price transparency trend
Once again, a major health insurer has raised the stakes on transparency of the prices charged by physicians, hospitals, clinical laboratories, and anatomic pathology groups. Blue Cross Blue Shield of North Carolina (BCBSNC) recently expanded a website for its members that lists what the insurer pays to different providers for various clinical services.
The database is searchable. Members have been able to access it since January of 2015. The website lists 1,200 non-emergency procedures, along with the average price that BCBS pays for each one.
Physicians Also Want Price Transparency
Consumers want more transparency of the prices charged by providers. But they are not the only group pushing for it. In a surprising twist, physicians in North Carolina were supportive of having their prices posted on a public website. (more…)
Feb 1, 2016 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology
Increased accuracy in listings should benefit in-network medical laboratories and anatomic pathology groups
Regional and smaller medical laboratories will welcome a new enforcement initiative by the Centers for Medicare & Medicaid Services (CMS). Health insurers now will face fines as high as $25,000 per beneficiary as a sanction from regulators in many states for errors in provider directories that can result in patients receiving surprise out-of-network bills.
As the number of consumers with high-deductible health plans has grown, the demand for more price transparency by physicians, hospitals, and other healthcare providers has increased, with states such as New Hampshire and Colorado legislating public price transparency websites.
Now the federal government is taking another step toward increased transparency in healthcare by fining payers whose provider directories are not current and include inaccurate listings that may cause consumers to unknowingly select out-of-network providers. This is especially important as insurance providers continue to narrow their provider networks. Increased accuracy in provider directories should help clinical laboratories and pathology groups that participate in insurance networks. (more…)
