Apr 5, 2013 | Digital Pathology, Instruments & Equipment, Laboratory Hiring & Human Resources, Laboratory News, Laboratory Operations, Laboratory Pathology
Advances in HIE technology and performance could prove beneficial to clinical laboratories and anatomic pathology groups
Even before most clinical laboratories have substantial experience with a full-function health information exchange (HIE) serving their region, one HIE expert is predicting that the next generation of HIEs is soon to arrive and will deliver more functionality.
“We’re maturing from HIE 1.0 to HIE 2.0,” declared Micky Tripathi. “We’re in a new world now.” Tripathi is in a position to know. He is CEO of the Massachusetts eHealth Collaborative. He also participates on the boards and/or steering committees of the Information Exchange Workgroup of the HIT Policy Committee, the eHealth Initiative, and the New England Health Exchange Network (NEHEN). (more…)
Mar 29, 2013 | Laboratory Hiring & Human Resources, Laboratory News, Laboratory Operations, Laboratory Pathology
Clinical laboratory and pathology data from the two of the state’s largest hospital systems will soon be available to providers using the CliniSynch HIE
Ohio’s statewide health information exchange (HIE) is gaining two prominent new members and both are located in the Cleveland metropolitan area. Cleveland Clinic and University Hospitals (UH)—two of the Ohio’s largest health systems—announced plans to connect to CliniSync Ohio’s statewide HIE.
Among other things, this will bolster the amount of clinical laboratory test data that can be accessed through the CliniSync HIE. That’s because both the Cleveland Clinic and University Hospitals operate sizeable medical laboratories that serve large populations of patients in Cleveland and the surrounding region. (more…)
Feb 22, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Uncategorized
Issue does not directly affect clinical laboratories and pathology groups, but puts spotlight on some hospitals and physicians who frequently use these codes.
Could increased use of electronic health records (EHR) systems be causing more hospitals and physicians to commit fraud because of upcoding? That’s the assertion of certain federal health officials. They attribute the increased proportion of Medicare claims for more complex and more expensive services by some providers to be, in some part, acts of fraud.
Most pathologists and clinical laboratory managers will notice the irony in these allegations that providers are upcoding services to Medicare patients in fraudulent ways. After all, the federal government is currently paying billions of dollars in financial incentives to encourage providers to implement and use certified EHR systems with the goal of lowering healthcare costs, while improving patient outcomes.
OIG Audit Findings Are Source of Fraud Allegations
Insinuations of provider fraud came after the public learned of findings of an audit done by Health and Human Services’ Office of Inspector General (OIG). The OIG determined that payments for more complex Level 5 E/M services increased by 21% between 2001 and 2010. During that same period, payments for medium-complexity patient services decreased by 11%.
For all of 2010, the Centers for Medicare and Medicaid Services (CMS) paid out $33.5 billion for E/M billings. This was about one-third of Medicare Part B payments for physician services. These numbers were part of a story published in Modern Healthcare.
Now that much larger numbers of physicians and hospitals are using electronic health record (EHR) systems, Medicare has noticed a steady increase in the proportion of claims submitted at higher and more complex codes, increasing reimbursement. In response to one federal government audit, Kathleen Sebellius, Secretary of Health and Human Services (r) and Attorney General Eric Holder (l) held a joint press conference to announce to healthcare providers that there would be stricter audits of providers who are using billing codes for complex patient visits with greater frequency. (Photo by Manuel Balce Ceneta, copyright Associated Press.)
(more…)
Dec 19, 2012 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Uncategorized
Change in who owns office-based physician groups is a trend which can create new winners and losers among the nation’s independent medical laboratories
Physicians today are more willing to practice medicine as employees than as partners or owners of their medical group. This signals a significant shift in the market for clinical laboratory testing and anatomic pathology services.
This new development will require that all medical laboratory organizations to rethink how they serve office-based physicians. New strategies will be required, both to better meet the clinical service needs of these employee-physicians, as well as to redirect sales and marketing programs to the new decision makers. (more…)
Nov 28, 2012 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Uncategorized
Unexpected opposition to EHR incentive program should be watched by pathologists and clinical laboratory managers
Questions about the value of the federal government’s program to encourage provider adoption of electronic health record (EHR) systems were raised by Republican leaders in both houses of Congress just weeks before the election on November 6.
Because clinical laboratories and pathology groups have a big stake in interfacing their laboratory information systems to physicians’ EHRs, this new development bears watching.
In October, GOP Senators and House Republicans joined together and issued a call for an immediate halt to distribution of incentive payments to providers for implementing electronic health record (EHR) systems. This program is now in its second full year of implementation. (more…)
