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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MACRA and Other Healthcare Reforms Cause Nearly Half of Physicians Surveyed to ‘Accelerate’ their Retirement Plans

Many pathologists and other physicians are accelerating their retirement plans as they become familiar with how MACRA, MIPS, and ADM will change the way the Medicare Program pays for physician professional services

Will Medicare’s make-over to how it pays physicians accelerate the retirement of more doctors—including pathologists? That’s the question many experts are asking as the nation’s physicians learn more about the rule to implement the Medicare Access and CHIP Reauthorization Act (MACRA), with its Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) programs.

With the Center for Medicare and Medicaid Services (CMS) expected this fall to finalize changes in how physicians—including pathologists—get paid for Medicare services, it appears many physicians are considering retirement, rather than contend with Quality Payment Program (QPP) rules for a new value-based reimbursement system and other healthcare reforms.

The Physicians Foundation’s latest biennial survey, “2016 Survey of America’s Physicians: Practice Patterns and Perspectives,” indicated that 46.8% of physicians plan to “accelerate” their retirement plans due to changes taking place in healthcare. That number rises to 50% among doctors age 46 and older, and to 54.2% among physicians who own their own practices. (more…)

Further Advances in the Healthcare Price Transparency Trend Reveal Why Physicians Are Supportive; Hospitals and Medical Labs Are Slow to Post Their Prices

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…)

Fee-for-Service Payment to Phase Out in Five Years? That’s the Recommendation of National Commission on Physician Payment Reform

Commission issues 12 recommendations to enhance physician and patient satisfaction, while creating a financially sustainable healthcare system

How quickly will fee-for-service disappear as a primary source of reimbursement for clinical laboratories, pathologists, hospitals, and physicians? If the recommendation of one credible group of physicians has its way, fee-for-service reimbursement could disappear in as little as five years.

This recommendation was made by National Commission on Physician Payment Reform as part of a report it issued in May. In its press release, the commission issued a call “for eliminating stand-alone fee-for-service payment by the end of the decade.” The group urges a transition over five years to a blended payment system that will yield better results for both public and private payers, as well as patients.” (more…)

Capitol Hill Hears Message from Independent Clinical Laboratory Owners: Additional Medicare Cuts in 2013 Can Be Financially Devastating

Nation’s smaller independent medical laboratories and pathology groups provide clinical lab testing services in many under-served communities

Nov. 21, 2012, WASHINGTON, DC—Last Thursday, owners of independent clinical laboratory companies fanned out across Capitol Hill to meet with their respective Senators and Representatives. Probably the number one concern of these lab owners was further cuts to the Medicare Part B Clinical Laboratory Test Fee Schedule.

Congress is preparing to tackle a host of spending issues, not the least which is the Medicare Sustainable Growth Rate sustainable growth rates(SGR). Earlier this year, in February, Congress raided Medicare Part B Clinical Laboratory Test Fees by $2.7 billion over 10 years to provide a source of funding to temporarily fix SGR. (See Dark Daily, “In Fixing Physician Medicare Pay, Congress Enacts Yet Another Cut in Clinical Laboratory Test Fee Schedule,” February 20, 2012.) (more…)

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