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…)
Jun 17, 2013 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Management & Operations
As ACO movement gathers momentum, hospitals and health systems see opportunities in providing health insurance
Hospitals and health systems are getting back into the health insurance business. Not only is this seen as an opportunity created by the development of accountable-care organizations (ACOs), but it may help the clinical laboratories of these same hospitals that serve office-based physicians in their communities.
This trend is another result of the Obamacare legislation. Some hospital systems are seizing an opportunity to expand their roles and grow revenue by once again getting into the health insurance business. Some experts believe this trend is likely to create more competition among insurers.
It may also accelerate the shift away from fee-for-service reimbursement to a global or bundled payment structure. As this occurs, medical laboratories will need to develop services that offer greater value to physicians and patients. (more…)
Mar 6, 2013 | Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Innovative care management models offer potential opportunities to expand medical laboratory testing services
Reducing hospital readmissions is a major goal and Walgreen Co. (NYSE:WAG) wants to do its part using a new medication management program. The retail pharmacy giant has entered contracts with about a dozen providers to deliver prescriptions to hospitalized patients and manage their medications for the first 30 days after discharge.
Pathologists and clinical laboratory managers know that preventable hospital readmissions cost the U.S. healthcare system approximately $25 billion per year. That figure was provided by a Walgreen’s press release. Among Medicare patients, about 20% are re-hospitalized within 30 days of discharge, the release stated.
“When a patient leaves the hospital with a new medication regimen, it can be overwhelming for both the individual and a caregiver,” observed Kermit R. Crawford, President, Pharmacy, Health and Wellness Division at Walgreens, in the release. (more…)
Aug 24, 2011 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
“Bundled Payments for Care Improvement Initiative” will be voluntary for hospitals, physicians, and other providers, including medical laboratories
Yesterday, Medicare officials took the first steps to implement a program for bundled Medicare payments by issuing documents which describe how this program would work. At least two of the four models for bundled reimbursement will include clinical pathology laboratory tests as part of the bundled care arrangement.
Clinical laboratory managers and pathologists will want to pay close attention to this development. The Centers for Medicare and Medicaid Services (CMS) titled this new effort the “Bundled Payments for Care Improvement Initiative.” It is a voluntary program. Only those providers who submit proposals and bids which are accepted will be paid through this program. The goal is to encourage different providers to collaborate on the care of a patient. Each of the four models for bundled healthcare has a slightly different payment arrangement.
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Aug 22, 2011 | Laboratory Management and Operations, Laboratory Operations, Laboratory Pathology, Management & Operations
Poor rates of growth in hospital revenue and admissions is not good news for clinical laboratories
During 2010, not-for-profit hospitals showed the lowest rate of growth in at least two decades, according to a report released by Moody’s Investors Service, a holding of Moody’s Corporation (NYSE: MCO). This may be an early sign that hospital laboratories will soon be asked to work with leaner budgets during the coming year.
In its report, dated August 10, 2011, financial analysts at Moody’s predicted a mean growth rate of 4% in revenue for not-for-profit hospitals. There are multiple and complex factors contributing to the drop in mean revenue growth of not-for-profit hospitals. The report authors wrote that:
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