Mar 20, 2015 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
In California, a survey found significant inaccuracies in provider directories posted online—may trigger action by regulators to have insurers address this problem
Transparency in healthcare is an important trend. In recent years, much attention has been given to increasing the transparency of the prices charged to patients by hospitals, physicians, and medical laboratories. But now the transparency trend is about to drive change in the provider directories that health insurance plans make available to their beneficiaries and consumers.
When choosing a health plan, many people look for insurance that includes their own physician, or at least a doctor close to home. That is why an accurate and up-to-date provider list is essential to consumer choice and access.
But many health insurers fall short in this regard. California recently released chastising reports on two of its major health plans, Anthem Blue Cross and Blue Shield (ABCBS) (NYSE:WLP) and Blue Shield of California, (BSCA) for publishing inaccurate provider lists on the state’s California Covered insurance exchange. (more…)
Jan 9, 2015 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Survey results show pathologists and clinical lab managers why largest health insurers have market clout and can exclude local labs from their provider networks
Over the past two decades, ongoing mergers and acquisitions of health insurance organizations have led to ever-greater concentration of market share, even as the number of large health insurance companies has shrunk. One consequence of this trend is that many clinical laboratories and anatomic pathology groups have lost access to managed care patients.
The degree of market concentration will surprise most pathologists and medical laboratory professionals. The concentration of market ownership is clearly demonstrated by the fact that the 25 largest health insurers in the United States now control two-thirds of this $744-billion market. But the largest plans are not necessarily the best, according to 2013 consumer satisfaction surveys conducted by J.D. Power & Associates. (more…)
Dec 17, 2014 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Study was published in Journal of the American Medical Association (JAMA) and showed how high-deductible healthcare plans are motivating consumers to use online transparency tools to search for providers that offer greatest value
Do consumers choose less expensive medical laboratories and imaging providers when they can see the prices in advance? The findings of a recently released study suggest that the answer is “yes”—that consumers will shop for the clinical laboratory with the cheapest test prices when they have access to price information!
This is one conclusion from a study of a half million consumers conducted by Castlight, Inc. (NYSE:CSLT), a San Francisco-based company that offers employers an online tool that enables their employees to compare healthcare pricing among their network providers. Researchers at Castlight confirmed that if consumers know the price of laboratory and imaging tests or physician visits in advance, they will choose the less expensive provider. (more…)
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…)
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…)
