Sep 3, 2013 | Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
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…)
Aug 30, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Managed Care Contracts & Payer Reimbursement
Confusion, unhappiness, and many unresolved issues remain about the way government and private payers are handling claims for molecular diagnostic tests covered by the 114 new CPT codes
Dust is settling from the fiasco triggered by the Medicare program’s failure to be ready on January 1, 2013, to settle molecular diagnostic test claims filed under the 114 new Tier 1 and Tier 2 molecular CPT codes. The damage is not just limited to Medicare test claims, but also involves private health plans that were waiting to let the Medicare program set precedents on coverage and prices for the new molecular test codes.
Many Clinical Laboratories Must Cope With an Unsatisfactory Situation
Although federal Medicare officials and Medicare contractors have scrambled to rectify the situation, even today there is much unhappiness across the clinical laboratory industry about the current state of things. That unhappiness extends to state Medicaid and private payers because many of these payers have been slow to publish coverage guidelines and prices for these new molecular test CPT codes.
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Aug 28, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Managed Care Contracts & Payer Reimbursement, Management & Operations, News From Dark Daily
In today’s tough financial environment, medical laboratories with effective Lean and Six Sigma improvement programs are showing the best financial performance
When Dark Daily wrote about how cost-cutting is now a major clinical laboratory industry trend last Wednesday, publication of that ebriefing triggered a flow of emails and commentary from readers far and wide.
Pathologists and medical laboratory managers who read Dark Daily tell us that they are facing painful decisions about where to cut. This is particularly true when labs cut expenses by reducing staff, laying off FTEs. This approach brings much emotional pain—along with the loss of valuable technical skills and extensive organizational experience that cannot be easily replaced.
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Aug 26, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Managed Care Contracts & Payer Reimbursement, Management & Operations, News From Dark Daily
Study Finds Most State Websites Aimed at Transparency in Healthcare Pricing Inaccurate and Basically Useless in Helping Consumers Shop for Services
With growth in high-deductible health plans, healthcare is becoming increasingly consumer-driven. But shopping for healthcare services isn’t easy due to lack of available resources that enable consumers to compare price and quality, according to a recent study published in the Journal of the American Medical Association (JAMA).
Recently, the U.S. Department of Health and Human Services (HHS) revealed the arbitrary nature of hospital prices by publishing hospital-specific costs and outcomes data for 3,000 hospitals nationwide, according to a report published by Dark Daily. This step towards full transparency is aimed at helping consumers comparative shop for hospitals based on both quality and value.
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Aug 21, 2013 | Laboratory Hiring & Human Resources, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
Many hospital outreach lab programs are dealing with the double whammy of successive reductions in Medicare Part B Clinical Laboratory Test fees and a shrinking budget by their parent hospitals
Over the past 24 months, all the painful cuts to lab test prices have made depressing news. These decreases in the prices paid to clinical laboratories by the Medicare program and major private health insurers mean that labs in 2014 will have significantly less revenue, even as the volume of specimens to be tested increases.
The logical response by many medical laboratory organizations has been to take active steps to decrease expenses. In fact, the price and revenue erosion experienced by labs of all sizes and types over the past two years is the reason why cutting unnecessary costs is now a primary management goal at clinical laboratories throughout the United States. (more…)
Jul 29, 2013 | Digital Pathology, Instruments & Equipment, Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations, News From Dark Daily
To solve this problem, clinical laboratories can contract with best in class vendors that will put screens on orders and results that filter out inconsistencies
In recent weeks the Department of Health and Human Services announced that more than 50% of doctors and 80% of eligible hospitals would be using electronic health record (EHR) systems by the end of 2013. Although federal officials are celebrating this accomplishment, for the clinical laboratory testing industry, EHR adoption, at best, has been problematic and, at worst, is a financial burden.
Despite increased connectivity, clinical laboratories have had create interfaces between their laboratory information systems (LISs) and the EHRs of their client physicians and hospitals. The federal officials who designed the financial incentives foster meaningful use among all clinicians for EHR adoption, but have not reimbursed labs for the substantial time and expense needed to establish these interfaces. (more…)
