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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The Affordable Care Act and the Consumer Experience: A Look at the Figures Over the Past Six Years for Clinical Pathology Laboratory Professionals

Much hype has been written about the ACA’s Healthcare Marketplace and the user’s experience. Does the reality measure up to the positive press coverage? Dark Daily takes a look

One major element of the Affordable Care Act (ACA) was to radically alter the health insurance industry while increasing the number of Americans with health coverage. As a consequence, both medical laboratories and anatomic pathology groups have experienced significant changes in how payers contract for, and reimburse, lab testing services.

These changes in payer contracting and reimbursement are just one way that the ACA is altering the landscape of healthcare in America. From C-suite executives of the nation’s largest health systems, to working-class families seeking coverage on the so-called “Health Insurance Marketplace,” everyone has been affected.

According to data from the U.S. Department of Health & Human Services, to date, approximately 20 million people have taken advantage of the provisions included in the ACA. However, a recent New York Times article pointed out that the reality of the consumer experience—how people actually use the ACA plans—differs somewhat from early reports. The whole thing’s turning out to be more complex than originally predicted.

Much hype has been written about the ACA. Pathologists and clinical laboratory managers should want to better understand the “real” experience for healthcare consumers after they (and providers) have endured six years of change associated with this federal law. (more…)

California Regulators Find Many Problems with the Provider Directories That Health Insurers Make Available to Consumers

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…)

Clinical Pathology Laboratories Ignore the Rapid Growth of Mobile Apps in Healthcare at Their Peril

Pathology groups and clinical laboratories have opportunity to use mHealth to add value to clinicians

Experts predict that healthcare’s use of mobile apps—now being described as mHealth—will evolve into a distinct and primary information channel that will play a significant role in clinical care. This includes how anatomic and clinical pathologists use laboratory medicine to support clinical care.

“[M]obile is a technology that winds its way through everything we’re doing and we’re planning to do,” declared Bryan Sivak, Chief Technology Officer at the U.S. Department of Health & Human Services (HHS), in a recent story published in Modern Healthcare (MH).”[It is] a channel to deliver content… a great way for us to collect more real-time information and connect physicians and patients with each other.” (more…)