Dec 9, 2013 | Coding, Billing, and Collections, Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Healthcare’s coming shift from fee-for-service to value-based reimbursement creates both a crisis and an opportunity for clinical laboratories and pathology groups.
With the era of fee-for-service medicine under siege, every clinical laboratory and anatomic pathology organization needs a strategy for getting paid, as new reimbursement models that support patient-centric care will make up a larger portion of lab revenues. Unfortunately, few real-world examples exist today to guide clinical laboratory executives as they develop these strategies.
Patient-centric medical care is an important goal for every healthcare provider. Patient-centered medical homes are enjoying strong growth and acceptance. Accountable care organizations (ACOs) are designed to serve the individual needs of each patient. Meanwhile, hospitals and physicians are getting better at measuring patient satisfaction because health plans are basing payment on these scores. (more…)
Apr 3, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Digital Pathology, Instruments & Equipment, Laboratory Hiring & Human Resources, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Managed Care Contracts & Payer Reimbursement, Management & Operations, News From Dark Daily
Financial and clinical fortunes may soon shift for many medical laboratory organizations
By every measure, the clinical laboratory industry is entering a high-stakes period during the next 24 months. Powerful trends are reducing lab budgets and payers are cutting the prices paid for medical laboratory testing. The question on everyone’s mind is “will it get better or worse in the months ahead?”
This question will be asked plenty of times to speakers at the nation’s largest gathering of clinical lab executives and pathology business leaders. On April 30-May1, the upcoming 18th Annual Executive War College on Laboratory and Pathology Management will take place in New Orleans, Louisiana. A record crowd has already registered to attend. (more…)
Nov 15, 2011 | Laboratory News, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
Registry for genetic tests and molecular diagnostic assays is one step in process to assess the science and clinical utility
Clinical laboratory and pathologists have dozens of questions about the proposed draft local coverage determinations (LCDs) that Medicare carrier Palmetto GBA issued on September 28. The draft LCDs represent Palmetto GBA’s efforts to identify the growing number of laboratory-developed molecular diagnostic assays and genetic tests.
In an exclusive interview with Dark Daily, Palmetto Medical Director Elaine Jeter, M.D., and Palmetto Vice President Mike Barlow explained the need for the new LCDs and offered insight into the process Palmetto GBA is developing to create a molecular test registry and a coverage determination and reimbursement process. This is an important development for the clinical laboratory industry. (more…)
Nov 11, 2011 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Instruments & Laboratory Equipment, Laboratory News, Laboratory Pathology
Palmetto wants to implement two proposed local coverage determinations (LCDs) on February 27, 2012
Medicare’s biggest local carrier is ready to tackle the problems created when clinical pathology laboratories use code stacks to submit claims for genetic tests and molecular diagnostics assays. Medical laboratories in eight states served by this Medicare carrier are worried about its two draft proposals that could cut off reimbursement for large numbers of molecular diagnostic tests (MDTs) and laboratory-developed tests (LDTs), starting February 27, 2012.
The Medicare carrier is Palmetto GBA, of Columbia, South Carolina. On September 23, it shook up the clinical laboratory industry and pathology profession nationwide when it announced, in a “draft proposal” for a local coverage determination (LCD), that it would not allow labs to submit claims for most MDTs. As noted above, the proposed effective date is February 27, 2012.
(more…)
Aug 24, 2011 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
“Bundled Payments for Care Improvement Initiative” will be voluntary for hospitals, physicians, and other providers, including medical laboratories
Yesterday, Medicare officials took the first steps to implement a program for bundled Medicare payments by issuing documents which describe how this program would work. At least two of the four models for bundled reimbursement will include clinical pathology laboratory tests as part of the bundled care arrangement.
Clinical laboratory managers and pathologists will want to pay close attention to this development. The Centers for Medicare and Medicaid Services (CMS) titled this new effort the “Bundled Payments for Care Improvement Initiative.” It is a voluntary program. Only those providers who submit proposals and bids which are accepted will be paid through this program. The goal is to encourage different providers to collaborate on the care of a patient. Each of the four models for bundled healthcare has a slightly different payment arrangement.
(more…)
