Jan 27, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Employers and health insurers want more consumers use healthcare cost estimator tools and pride when choosing a hospital, physician, or clinical laboratory
Having put millions of consumers into high-deductible health plans (HDHPs) as one way to control healthcare costs, both employers and health insurers are now challenged to help these same consumers do better at using price and quality factors when selecting providers.
One solution to this problem is to encourage physicians to play a greater role in helping their patients use price and quality when it is time to select a provider. Obviously, these decisions can involve which clinical laboratory or anatomic pathology practice a patient should select when he or she needs medical laboratory testing.
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Feb 15, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology
Raising the out-of-pocket costs for Medicare beneficiaries with Medigap policies not likely to be favorable for medical laboratories
If federal officials have their way, Medicare beneficiaries with comprehensive Medigap polices are likely to pay a greater share of the cost of their medical care. The goal is to reduce use of unnecessary medical services and save Medicare money.
For clinical laboratories and anatomic pathology groups, this may not be a welcome development. That’s because any requirement for labs to collect more money directly from Medicare beneficiaries will raise the cost of billing and collections—even as medical laboratories also see a rise in bad debt from Medicare beneficiaries, who are not accustomed to paying any money out-of-pocket for most of their medical laboratory tests.
May Be Some Good News for Pathologists
However, there is some good news for pathologists and clinical laboratory managers in this story. A credible source has warned the federal government that increasing the Medicare beneficiary’s costs will not reduce unnecessary utilization of healthcare services. Nor will it save the Medicare program any money. In fact, such actions may have the opposite effect!
The government is considering requiring higher out-of-pocket cost sharing from the 9 million seniors with Medigap policies to cut down on use of unnecessary medical services. The National Association of Insurance Commissioners contend, however, that this would raise Medicare costs over time. (Graphic by Kaiser Health News)
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Jul 10, 2009 | Laboratory News, Laboratory Pathology
List of recommendations based on UnitedHealth’s extensive database and experience
Every sector of the healthcare industry is offering both Congress and the Center for Medicare & Medicaid Services (CMS) advice on how to reform the system to improve quality of care, while reducing costs. Too often, the search for ways to save money that can be redirected to covering uninsured is a game of taking money from one existing health service and shifting it to another.
Recently UnitedHealth Group (NYSE:UNH) stepped into this debate over how to save money. In important ways, it is better positioned to provide this advice than most other entities. For example, UnitedHealth Group is the nation’s largest insurer in terms of revenue. UNH funds and organizes care for 70 million Americans. It arranges $115 billion in health care services provided by 5,000 hospitals and 650,000 physicians nationwide. Because of this, UNH’s Center for Modernization and Reform has collected more data on clinical services provided and resulting healthcare outcomes than anyone else.
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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 25, 2009 | Laboratory News, Laboratory Pathology
As previously suggested by earlier Dark Daily e-briefings, studies of the 46 million uninsured Americans suggest there’s more to this statistic than a big number implies. Up to two-thirds of the uninsured either qualify for government-sponsored insurance or could afford to buy coverage.
But no one disagrees that widespread layoffs and elimination of employer-sponsored health coverage are causing the ranks of the uninsured to swell. For every worker who loses health benefits, the multiplier is 3.14-the average size of the U.S. family. Thus, the loss of 3 mllion jobs over the last year translates to about 9.4 million people losing health coverage.
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