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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Medical Tourism Continues to Flourish as U.S. Patients Seek Lower Cost Healthcare in Overseas Countries

Pathology groups and medical laboratories here in the United States still have few opportunities to provide reference or esoteric diagnostic services to healthcare providers in other countries

Despite the lack of publicity, medical tourism continues to enjoy vigorous growth as an increasing number of Americans prove willing to cross international borders to obtain healthcare that is considered of acceptable quality, but at a price that significantly cheaper than here in the United States.

What makes the trends in medical tourism relevant for clinical laboratory managers and pathologists is that it shows how U.S. consumers are reacting to high healthcare prices and other problems within the American healthcare system. In particular, our nation is experimenting with putting tens of millions of Americans in high-deductible health plans. How these consumers decide to price-shop because of their $3,000 to $10,000 per year individual and family deductibles remains to be seen. < (more…)

Major Healthcare Systems Begin Building In-House Whole Human Genome Sequencing Capabilities, Creating New Opportunities for Pathologists

Partners HealthCare and Geisinger Health are among health systems making investments and developing the clinical utility of genome sequencing

Next-generation gene sequencing is making fast inroads among the nation’s largest academic centers and health systems. This is an auspicious development for the clinical laboratory industry. It positions pathologists to play a greater role in clinical care and genetic medicine.

News accounts and published research suggest that mega systems—including Partners HealthCare, Geisinger Health System, Scripps Health, and Medical College of Wisconsin—are among first movers investing in genome-sequencing equipment and assembling the medical expertise necessary to establish genetic-testing programs and help physicians utilize gene sequences where appropriate for patient care. (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…)

Medical Laboratory Leaders Gather in the United Kingdom to Address Challenges of Shrinking Lab Budgets and Need to Upgrade Quality Assurance Performance

Nation’s healthcare system is in the midst of major clinical, organizational, and financial reforms—many of which require immediate responses by pathology laboratories

BIRMINGHAM, England—Two major challenges in laboratory medicine were front and center this week when medical laboratory, a professionals and histopathologists gathered here in the United Kingdom (UK) for the eleventh annual Frontiers in Laboratory Medicine (FiLM).

One challenge is how to improve the quality of lab testing services and demonstrate value to payers. The other challenge is how medical laboratories in the UK  can cope with shrinking budgets for medical laboratories. (more…)

New York’s Mount Sinai Medical Center Using Big Data to Improve Clinical Care

Big data is poised to change the healthcare ecosystem and that creates opportunities for forward-looking medical laboratories

First-mover academic center, Mount Sinai Medical Center (MSMC), is taking steps to incorporate “big data” into the daily patient-care setting. For the medical laboratory industry, this is a signal event because a major component of healthcare big data will be patient genetic and molecular information.

Included on MSMC’s big data team are  its genetics laboratory experts. These are high-profile “data scientists” who help doctors make personalized predictions about their patients. This project shows how integrated healthcare informatics—including clinical laboratory test data—will be a key attribute of healthcare moving forward.
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Health Insurers Encourage Physicians to Help Patients Use Cost and Quality Data to Select Providers, Including Medical Laboratories

Employers and health insurers want more consumers use healthcare cost estimator tools and pride when choosing a hospital, physician, or clinical laboratory

Having put millions of consumers into high-deductible health plans (HDHPs) as one way to control healthcare costs, both employers and health insurers are now challenged to help these same consumers do better at using price and quality factors when selecting providers.

One solution to this problem is to encourage physicians to play a greater role in helping their patients use price and quality when it is time to select a provider. Obviously, these decisions can involve which clinical laboratory or anatomic pathology practice a patient should select when he or she needs medical laboratory testing.

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