Mar 6, 2015 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
After seeing a rise in the volume of clinical lab tests physicians order, managed care plans are develop a variety of strategies to manage utilization and costs
Health insurers are taking more aggressive actions to control the cost of clinical laboratory testing. For many years, clinical laboratories and pathology groups have been concerned about the strategies used by Medicare to control the utilization and costs of medical laboratory tests. Private health insurers usually follow the actions of Medicare, the nation’s largest health insurer. But today, managed care plans are developing their own lab-test-utilization strategies in addition to following those of Medicare.
Recently, Managed Care magazine explained many of the steps health insurers take to keep the costs of clinical laboratory tests under control. The cover story in the October issue of the magazine, “Health Plans Deploy New Systems To Control Use of Lab Tests,” outlined how health insurers Cigna, Group Health Cooperative, Priority Health, and UnitedHealthcare (UHC) are managing lab test utilization. (more…)
Feb 28, 2014 | Coding, Billing, and Collections, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
BIDMC researchers show that, on average, 30% of all lab tests may be unnecessary and that an equal percentage of tests should not be ordered at all
Every pathologist and clinical laboratory professional knows how often physicians order a medical laboratory test that is inappropriate or unnecessary. That is a problem because, each time a clinician orders an inappropriate test, patient harm is possible. Yet this issue gets little attention from the medical profession at large.
Thus, it is significant that researchers at Beth Israel Deaconess Medical Center (BIDMC), published a study last fall showing that 30% of all medical laboratory tests throughout medicine are overused! A different 30% of medical laboratory tests are underused, as well. (more…)
May 28, 2013 | Coding, Billing, and Collections, Laboratory News, Managed Care Contracts & Payer Reimbursement, Management & Operations
Giving physicians Information on the price of medical laboratory tests at the time of order decreased overall use of such tests by about 9%, researchers said.
Physicians order fewer clinical laboratory tests when they know how much they cost, according to a recent study at the Johns Hopkins University School of Medicine.Those findings are good news for hospital-based pathologists who must often respond to physicians who order expensive esoteric tests that are inappropriate for the patient’s condition or lack documentation as to clinical utility.
The study results show another dimension to the power of transparent pricing in healthcare because it demonstrates that physicians are willing to take cost into consideration when deciding what clinical laboratory tests they should order. Some experts believe that publishing price information on the costs of care empowers consumers to shop for the best price, thus helping to reduce the overall cost of healthcare.
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May 30, 2012 | Instruments & Equipment, Laboratory Instruments & Laboratory Equipment, Laboratory News, Laboratory Operations, Laboratory Pathology
Researchers say they can see, identify, and count blood cells in vivo, with a system that could eventually move some routine high-volume tests out of centralized medical labs
It would be disruptive to many medical laboratories if routine hematology testing—particularly the traditional complete blood count (CBC)—were to move out of the central clinical laboratory and become a real-time, non-invasive point-of-care test (POCT) that provides the same information that is similar to the traditional complete blood count (CBC).
Israeli researchers developed a microscope with cellular resolution that uses a rainbow of light to image blood cells in vivo as they flow through a microvessel. Experts familiar with the research project say the technology has the potential to find a ready role in clinical diagnostics. (more…)
Mar 30, 2011 | Laboratory News, Laboratory Pathology
Another example of clinical pathology laboratory testing treated as a commodity
In-office anatomic pathology laboratories owned by specialist physicians have sparked a troubling trend for the pathology profession in recent years. In the United States, growing numbers of urologists, gastroenterologists, and dermatologists have taken steps to build out and operate their own in-office surgical pathology testing laboratories.
Specialist physicians took steps to open their own in-clinic medical laboratories as a way to generate revenue to offset reimbursement declines in their professional compensation. And, yes, it is true that an in-office anatomic pathology laboratory may have other benefits, such as reducing the turnaround time from specimen collection to reported result. (more…)
