Jul 26, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations, Uncategorized
Clinical laboratories and pathology groups may want to review the prices they charge insured patients versus uninsured patients
There is a certain irony in the fact that hospitals and other medical providers typically charge patients without health insurance as much as three times what they charge Medicare or an insured patient. This situation is getting increased media scrutiny, which is one reason why clinical laboratories and pathology groups may want to review their own policies for charging patients without health insurance.
One good study on prices charged to self-pay patients was conducted by Gerard Anderson, Ph.D., a health economist at the Johns Hopkins Bloomberg School of Public Health. His study was funded by the Henry J. Kaiser Family Foundation and published in the May-June 2007 journal Health Affairs.
Anderson analyzed 2004 hospital billing data. He concluded that the gap between rates charged self-pay and insured patients has grown substantially since the mid-1980s. “In the 1950s, the uninsured and poor were charged the lowest prices for medical services. Today they pay the highest prices…,” wrote Anderson, noting that self-pay charges often reflect the hospital’s “chargemaster” prices–the top prices used to negotiate discounts with insurers. (more…)
Jun 17, 2009 | Laboratory News, Laboratory Pathology
Clinical laboratories can provide that missing education about CDHPs to patients
Even as enrollment in Consumer-Directed Health Plans (CDHPs) and Health Savings Accounts (HSAs) climbs steadily year after year, a new study reveals that most physicians are unprepared to help their patients understand and better use these forms of health insurance. This is a barrier to CDHP acceptance and an opportunity for clinical laboratories.
CDHPs—and their close cousins, HDHPs (high-deductible health plans_—are designed to shift more responsibility for healthcare decisions to patients. Many physicians, however, are unprepared to advise patients enrolled in CDHPs about cost-effective treatment options. This is the finding of a 2008 survey of 525 randomly selected doctors published in the American Journal of Managed Care . Nearly half, 43%, of doctors responding to the survey admitted knowing “a little” or “not at all” about CDHPs or HSAs. At least 33% of surveyed physicians said they are “somewhat” knowledgeable. Only 24% of physicians surveyed claimed “much” or “a great deal” of knowledge about CDHPs.
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Mar 30, 2009 | Laboratory News, Laboratory Pathology
Medical Group Management Association (MGMA) recently launched Project SwipeIT. This is an ambitious project to motivate the entire healthcare industry to adopt an electronic patient ID system by the end of 2009! The initiative asks insurers, providers, vendors and professional groups to commit to the deadline, as outlined by the Project SwipeIt portal on MGMA’s Website.
MGMA, a trade association of medical practice management professionals, estimates a nationwide electronic patient ID system could save providers $1 billion annually in unnecessary administrative costs and denied claims. Pathologists and laboratory administrators know that adoption of electronic patient ID would be a great benefit for clinical laboratories and pathology group practices.
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