News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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New Study Indicates Shopping Tools Alone Might Not Lower Medical Spending, Even Though More Patients Want to Know Prices for Clinical Laboratory Tests and Other Procedures

JAMA study finds that most workers with access to web-based price comparison tools did not use them, nor did they spend less on medical care than other workers

Can shopping tools designed to help patients compare providers (including medical laboratories), quality, and prices, make a contribution to reducing the increase in healthcare costs? A new study suggests that such shopping tools make only modest contributions to controlling the cost of care.

Published May 3 in the Journal of the American Medical Association (JAMA), the study found that only 10% of the 150,000 employees at two large companies offering web-based transparency tools logged on to compare healthcare costs during the calendar year. In addition, providing workers with the ability to shop for healthcare services did not bring down employees’ average outpatient spending. Instead, employees with access to transparency tools spent slightly more than workers who could not price shop.

“Our findings temper the enthusiasm around the idea that price transparency is some sort of panacea … that price transparency alone, coupled with high deductible health plans, are going to lead to reduced spending,” stated Sunita Desai, PhD, a Seidman Fellow in Healthcare Policy at Harvard Medical School who led the study. She was quoted in a Washington Post article. (more…)

Oregon’s New Medicaid Care Model Uses Capitated Reimbursement and Coordinated Care Organizations; May Change How Clinical Laboratories Are Paid

Other states are studying Oregon’s innovative Medicaid experiment, which could lead to different forms of reimbursement for clinical laboratories

Once again, Oregon’s Medicaid program is blazing a new trail in the delivery of healthcare. This time, Oregon is organizing its Medicaid services—known as the Oregon Health Plan—to do two things. First, it is developing 16 coordinated care organizations (CCOs)  across the state. Second, those Medicaid beneficiaries who represent the majority of costs to the program will receive special case management and clinical services.

Because there will be capitated payments to providers under this program, clinical laboratory managers and pathologists will want to understand how medical laboratories will be reimbursed by the Oregon Health Plan. (more…)

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