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…)
Mar 28, 2012 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
NCQA published annual report showing increased rates of screening for most of its HEDIS quality measures and medical laboratory testing often plays a role in these screening activities
For almost a decade now, clinical laboratories and pathology groups have been asked by many private payers to provide laboratory test data for a number of clinical services. In turn, these private health insurers annually submit this data to the Healthcare Effectiveness Data and Information Set (HEDIS) program managed by the National Committee for Quality Assurance (NCQA).
Although their medical laboratories regularly feed this data to payers, few pathologists or lab administrators track how HEDIS data is used by NCQA. Thus, it is useful to know that, over the years, HEDIS data provides evidence that better utilization of certain clinical laboratory tests by physicians directly contributes to measurable improvements in patient outcomes across the United States.
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Mar 14, 2011 | Laboratory News, Laboratory Pathology
Efforts to improve transparency still don’t include clinical pathology lab data
Veterans, their family members and their healthcare providers can now go online to compare the performance of their local Department of Veterans Affairs (VA) hospital against other VA hospitals. This new service launched just last year.
That is when the VA opened its Hospital Compare website to the public. This important step is consistent with the VA’s declared intent to achieve total transparency in veteran’s healthcare. Pathologists and clinical laboratory managers will want to check out this website to see how the quality performance of different VA hospitals is presented to patients and the public.
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Feb 21, 2011 | Laboratory News, Laboratory Pathology
Medicare officials continue to work toward improved transparency in provider outcomes
Medicare officials are making progress in their efforts to help patients “shop” for doctors, including pathologists. It has gone live with a new website called “Physician Compare.” This website offers many search functions not previously available.
The Centers for Medicare and Medicaid Services (CMS) put up the new website to fulfill one mandate of the healthcare reform law, known as the Patient Protection and Affordable Care Act (PPACA) of 2010. CMS expanded the information available to healthcare consumers on its online physician directory tool. (more…)
Dec 1, 2010 | Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
Still No Medicare Quality Measures for Clinical Laboratories and Pathology Groups
Transparency in provider outcomes is moving one step forward and this time it’s a new bonus plan for Medicare Advantage plans. The Centers for Medicare and Medicaid Services (CMS) believes the enhancement will encourage lower performing plans to improve their quality of care.
Quality Measures Should Interest Medical Laboratory Managers
Pathologists and clinical laboratory managers will be interested to learn that, during the 3-year demonstration project, bonuses of 5% will be paid to Medicare Advantage plans that achieve a 5-star rating. Lesser bonuses will be paid to those plans that achieve three to four stars. A new twist is that this update also includes a new “low performer” icon to alert Medicare Advantage recipients of plans that earn less than three stars over a 3-year period.
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