Jan 6, 2016 | Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Testing, Management & Operations
Tableau Software, IBM, Apple and others are building a future where analysis of clinical data guides personalized medicine, fuels research, and helps reduce healthcare costs
Use of big data in healthcare is poised to become a big business. That’s because new players in data analytics have begun to help providers and accountable care organizations (ACOs) effectively use data to improve their business operations, personalize care for patients, and/or discover new medical insights.
Because more than 70% of a typical patient’s permanent medical record consists of clinical laboratory laboratory test data, pathologists and medical laboratory scientists have a stake in the growth of big-data analytics, which are a core component in healthcare’s journey toward personalized medicine. (more…)
Dec 18, 2015 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
AJMC study shows ACOs that allocate majority of shared savings to primary care providers are more likely to generate savings
When it came time to pay bonuses to Medicare’s Pioneer ACOs and Shared Savings Program (MSSP) ACOs based on 2014 results, a substantial proportion of the payments went to primary care physicians compared to hospitals and specialist physicians. Significantly, only a minority of these ACOs qualified for bonus payments.
Pathologists and clinical laboratory managers watching the growth of ACOs will find it notable that primary care doctors received 46% of the shared-savings bonuses in the program’s first two years. Hospitals received 27% of the incentives while 20% went to specialists, according to a Modern Healthcare report.
High Expectations That ACOs Can Help Control Healthcare Costs
Twenty Pioneer ACOs and 333 Medicare’s Shared Savings Program (MSSP) ACOs combined to produce more than $411 million in total savings in 2014, although only 29% of the organizations generated enough savings to earn a bonus, a CMS Fact Sheet indicated.
“These results show that accountable care organizations as a group are on the path towards transforming how care is provided,” stated CMS Acting Administrator Andy Slavitt in a statement. “Many of these ACOs are demonstrating that they can deliver a higher level of coordinated care that leads to healthier people and smarter spending.” (more…)
Dec 14, 2015 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Example is a big data-based study involving Optum and Mayo Clinic that indicates diabetes management can be too aggressive for some patients
Mayo Clinic has tapped Optum Labs’ huge data set to fuel research suggesting diabetes management can be too aggressive among those diabetics who don’t have problems controlling their glucose level. Optum Labs’ data is also being mined to investigate dozens of research initiatives, including a major fight against Alzheimer’s disease. These projects provide a glimpse into the growing role of big data in healthcare.
Because more than 70% of a typical patient’s permanent medical record consists of clinical laboratory test data, pathologists and medical laboratory scientists have a stake in the growth of big-data analytics, which are a core component in healthcare’s journey toward personalized medicine. (more…)
Nov 25, 2015 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
Clinical laboratories and pathology groups can expect to see more growth in the number of patients served by ACOs and that will require labs to have a new pricing strategy
Will ACOs be the next big thing in American healthcare? Many people are betting that will be true as the number of ACOs continues to increase. Some reports indicate that as many as 750 Medicare and private ACOs were in operation as of early 2015, compared to about 250 ACOs in 2013.
Pathologists and clinical laboratory managers watching the ACO trend will find it significant that Medicare ACOs now serve about 5.6 million beneficiaries. According to a report issued by Oliver Wyman, that is about 11% of all Medicare beneficiaries. Providers in these ACOs are paid under a different arrangement than the long-established Part B fee-for-service price schedule.
The big question mark about ACOs is whether they can deliver significant cost savings while improving patient outcomes. This summer, officials at the federal Centers for Medicare & Medicaid Services (CMS) reported on the savings generated by the agency’s pilot ACO programs. The two main accountable care organization programs are the Medicare Shared Savings Program (MSSP) and the Pioneer ACO Program. (more…)
May 1, 2015 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
If bundled payment becomes more common in treatment of cancer, then anatomic pathologists need a strategy to demonstrate their clinical value to physicians and payers
MD Anderson Cancer Center and UnitedHealthcare (NYSE: UNH) announced a bundled payment agreement for the treatment of certain types of cancer. This development has implications for anatomic pathologist who provide cancer testing services to hospitals throughout the United States.
The new three-year pilot at MD Anderson’s Head and Neck Center in Houston, Texas, is the first use of a bundled payment model in a large, comprehensive cancer center. Officials say it is expected to lower costs while improving the quality of patient care and outcomes. As many as 150 patients with head and neck cancer who are enrolled in employer-sponsored UnitedHealthcare (UHC) plans will participate in the pilot.
“For the last five years, MD Anderson and its Institute for Cancer Care Innovation have been looking at how to best approach a single price for treating cancers. It is a complex question because cancer is a complex disease and each patient unique,” stated Thomas W. Feeley, M.D., Head of Anesthesiology and Critical Care, and Head of the Institute, in an MD Anderson news release. “Bundled pricing is something that patients and care providers want, and this is our first opportunity to better understand how we can manage costs without sacrificing quality care and patient outcomes.” (more…)
