Jun 13, 2012 | Compliance, Legal, and Malpractice, Laboratory Hiring & Human Resources, Laboratory News, Laboratory Pathology
Clinical laboratory managers and pathologists will want to develop strategies for adding value under ACO model
One lesson learned from a pilot accountable care organization (ACO) project is that increased utilization of clinical laboratory testing in appropriate circumstances will contribute to improved patient outcomes. Just one year into a pilot ACO partnership, Norton Healthcare and insurer Humana Inc. (NYSE: HUM) have shown quality gains and some modest savings.
This is encouraging news for pathologists and clinical laboratory managers. It shows that, when physicians participating in ACOs more closely follow evidence-based medicine (EBM) guidelines, the increase in lab test utilization can play the expected role in improving diagnosis and guiding therapeutic choices. However, it should be noted that the results disclosed by the Norton/Humana ACO pilot only cover a short period of time. (more…)
Apr 11, 2012 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Clinical laboratories and pathology groups may need to re-strategize should hospital inpatient admission rates begin declining as a result of proactive clinical care programs
More hospitals are ramping up their services in proactive outpatient care. The goal is to reduce hospital admissions and curb costs. The challenge is that fewer admissions and shorter stays mean a drop in hospital revenues. For the hospitals’ clinical laboratories, it also means less inpatient lab test volumes.
Hospitals are doing this in response to changes in reimbursement models specifically designed to incentivize providers to keep people out of hospitals. Of all sites that deliver patient care, hospitals account for the greatest share of the nation’s healthcare dollar. This makes them a prime target for cost cutting, noted a recent story in Modern Healthcare (MH).
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Jun 21, 2011 | Laboratory News, Laboratory Pathology, News From Dark Daily
Major healthcare stakeholders speaking out with criticisms of federal ACO rules
It may be that the Obama administration bit off more than it can chew with its first release of proposed rules for Accountable Care Organizations (ACO). Lining up in opposition to these rules is an impressive list of the nation’s most respected healthcare organizations. Included are Mayo Clinic, Geisinger Health System, Cleveland Clinic, and Intermountain Healthcare.
Pathologists and clinical laboratory managers will undoubtedly recognize the significance of this opposition. Health officials within the Obama administration have regularly stated that ACOs should be organized to deliver the same type of tightly integrated healthcare that is the standard at Mayo Clinic, Geisinger Health, Cleveland Clinic, and Intermountain Health. Thus, it is not auspicious for the Obama administration that these four institutions are making public statements that, under the ACO rules as now written, they are not inclined to participate.
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Jun 15, 2011 | Laboratory News, Laboratory Pathology
Watson is capable of assessing health data, including medical laboratory test results
When IBM’s Watson “supercomputer” squared off against human contestants on the Jeopardy game show last February, there certainly were some pathologists and clinical laboratory managers watching this “man versus machine” battle of knowledge. But those pathologists and medical lab managers did not realize that IBM intends for Watson to play a major role in helping physicians diagnose and treat disease.
IBM is designing Watson to use analytical algorithms to support how physicians assess information as they evaluate patients. In this role, it is likely that Watson will be fed laboratory test data and evidence-based medicine algorithms as part of the data it draws upon to help physicians more accurately diagnose disease and come up with appropriate treatment plans. (more…)
May 31, 2011 | Laboratory Pathology, News From Dark Daily
Prominent national health associations publish tough criticisms of the new final ACO rule
Pathologists and clinical laboratory managers have a ringside seat as the fight to introduce Accountable Care Organizations (ACO) gets underway. On one side is the federal government, represented by the Department of Health and Human Services (HHS). On the other side are a number of the nation’s most important healthcare organizations.
It is a fight that is heating up. The latest round came just weeks ago, when, on Tuesday, May 17, 2011, HHS unveiled its plan to accelerate the creation of Accountable Care Organizations (ACO) in this country, including publishing the final rule. It took just days for criticism from major healthcare organizations to fill the new reports.
For its part, HHS believes the new ACO model will save Medicare as much as $430 million over three years. However, many healthcare organizations publicly state that this ACO model contains more risks than rewards. They believe it places an unmanageable reporting burden on the hospitals and physicians that participate in the ACO.
Healthcare Organizations Criticize HHS’ new ACO Model Final Rule
Take the American Medical Group Association (AMGA), for example. Executives representing this influential association expressed their membership’s concern about the ACO proposal. In a letter to Donald Berwick, M.D., Administrator for the Centers for Medicare and Medicaid Services (CMS), the AMGA officials wrote that “In an AMGA survey of its membership, 93% of respondents stated that they would not participate in the ACO program unless the requirements in the final rule reflect major modifications to the proposals.”
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