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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Hoping to Become Heavyweights in Healthcare Big Data, IBM Watson Health Teams Up with Siemens Radiology and In Vitro Diagnostics Businesses

Big data offers new opportunities for healthcare providers, clinical laboratories, and pathology groups, and this new alliance hopes to accelerate big data capabilities

Big data has the potential to deliver unprecedented insight into optimizing the patient care experience and managing outcomes for healthcare providers. That is particularly true for clinical laboratories, and pathology groups. Yet, with the sheer amount of data generated by today’s ever-expanding menus of diagnostic procedures, communicating this data between systems and analyzing data at high-levels still presents challenges.

To help healthcare organizations jumpstart their Big Data programs, key stakeholders are joining forces. One such alliance involves Siemens Healthineers and IBM Watson Health. In an October 2016 press release, the two organizations announced a five-year global strategic alliance aimed at helping healthcare professionals optimize value-based care that leverages increasingly complex data collected for use in precision medicine.

What should intrigue pathologists and medical laboratory managers about this new alliance is the fact that Siemens Healthineers owns two of the world’s largest businesses in radiology/imaging and in vitro (IVD). Thus, it can be expected that the alliance will be looking to identify ways to combine radiology data with clinical laboratory data that produce knowledge that can be applied to clinical care. (more…)

Healthcare Strategist Predicts that Skyrocketing Costs of Cancer Care May Soon Exceed the Value of New Medical Laboratory Tests and Therapeutic Drugs for Cancer

With cancer care costs soaring, will health insurers be asking whether the patient outcomes justify new and expensive diagnostic and therapeutic advances?

Medical laboratory companies offering expensive molecular tests for cancer and pharmaceutical companies that sell super-expensive cancer drugs are ready to hit the financial wall with payers and the healthcare system. That’s the opinion of Paul Keckley, Ph.D, a widely-read healthcare strategist.

Keckley warns that the cost of cancer care management is nearing a tipping point where the relative value of innovations may no longer outweigh the cost. In this new environment, Keckley expects pathologists, medical laboratory scientists, and others working in cancer care to face challenges over the cost-effectiveness of their diagnostic and therapeutic advances. (more…)

Big Health Insurers Acquire Health IT Horsepower to Support Their Accountable Care Organizations

Actions by major insurers indicate that ACOs operated by hospitals will have competition

Until recently, most media coverage about nascent accountable care organizations (ACOs) centered on the plans of major hospitals and health systems to organize ACOs within their communities. Now comes news that major health insurers are making sizeable investments as they prepare to launch their own ACOs.

These developments could be auspicious for local clinical laboratories and anatomic pathology groups. It could mean that in many regions around the United States there will be ACOs operated by hospitals/health systems that compete against ACOs operated by health insurance companies. In turn, that would mean more customers for lab testing services in these cities and towns.

Federal Government Agrees to Open Access to Medicare Data about Individual Doctors

Experts predict employers will use this data to create “report cards” on individual physicians

In a big step forward for public access to data about provider outcomes, the Department of Health and Human Services (HHS) will make its enormous Medicare claims database more broadly available to the public. Both the press and the public will be able to search for information about individual physicians. It is likely that information about pathologists will be searchable in this manner.

Specifically, Medicare will relax its restrictions on the release of information about individual doctors who participate in Medicare. This development was reported recently by The Wall Street Journal, which played a role in getting HHS to make physician data available to the public.

“This is a giant step forward in making our health care system more transparent,” stated Marilyn Tavenner, Medicare’s Acting Administrator. (more…)

Aetna, Humana, Kaiser, UnitedHealth Put Five Billion Medical Claims into Database for Healthcare Cost, Utilization Research

Data represents $1 trillion in spending since 2000 and contains clinical laboratory and pathology data

In what may turn out to be a positive development for clinical laboratories and pathology group practices, four of the nation’s five biggest health insurance companies will collaborate and put their medical claims data for billions of transactions into a single data base. Researchers say this database will give them an unprecedented ability to assess utilization trends and the clinical care delivered to patients covered by private health insurance.

The four health insurance companies that will provide data are:

The data provided by each of these health insurers will be submitted to the newly-created Health Care Cost Institute (HCCI). This data will consist of more than five billion medical claims dating back to 2000. These claims represent more than $1 trillion in spending. The health insurers are also providing the financing required to launch HCCI. (more…)