Tag: clinical laboratories

Northwell Health Lab Team Leverages Data to Add Value

By Joseph Burns, from the Volume XXVI No. 8 – June 10, 2019 issue

CEO SUMMARY: Today, insurers get risk-adjusted payments for treating patients who have high-cost health conditions and they make risk-adjusted payments to physicians, hospitals, and other providers. At Northwell Health, the clinical lab saw the opportunity to leverage lab test data with other clinical and demographic data to identify patients who were undiagnosed or whose conditions were

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TriCore Finds Value-Based Healthcare a Profitable Endeavor

By Mary Van Doren, from the Volume XXVI No. 7 – May 20, 2019 issue

This is an excerpt from a 3,380-word article in the May 20, 2019 issue of THE DARK REPORT. The full article is available to members of The Dark Intelligence Group.

CEO SUMMARY: To develop new sources of revenue to offset declining fee-for-service payments, TriCore Reference Labs is collaborating with health insurers in novel ways to improve patient

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May 20, 2019 Intelligence: Late Breaking Lab News

By Robert Michel, from the Volume XXVI No. 7 – May 20, 2019 issue

Canada faces a similar shortage of medical technologists (MTs) as exists in the United States. “We have reached the point now where some laboratories have been closed for weeks due to insufficient staffing, which is a cascading problem for patients and the healthcare system,” stated Maria Klement, President of the Canadian Society for Medical Laboratory

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TriCore Forges Ahead to Help Payers Manage Population Health

By Joseph Burns, from the Volume XXVI No. 7 – May 20, 2019 issue

CEO SUMMARY: To develop new sources of revenue to offset declining fee-for-service payments, TriCore Reference Labs is collaborating with health insurers in novel ways to improve patient outcomes and lower healthcare costs. To achieve this, TriCore brings together data from lab tests, EHRs, patient demographics, and geography. Analytical tools allow it to assess population health

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CMS, Lab Groups Begin Talks About Issues with NCCI Edits

By Joseph Burns, from the Volume XXVI No. 7 – May 20, 2019 issue

SERIOUS PROBLEMS WITH THE NEW GUIDELINES for the National Correct Coding Initiative (NCCI) that were implemented on Jan. 1 have caused nine clinical laboratory associations and groups to come together and voice their concerns to the federal Centers for Medicare and Medicaid Services (CMS).

CMS implemented those changes on Jan. 1, resulting in confusion among labs

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What Labs Can Expect from PAMA in 2019

By Joseph Burns, from the Volume XXVI No. 7 – May 20, 2019 issue

CEO SUMMARY: Attendees at the Executive War College learned that CMS has taken steps to expand the number of hospital labs required to report their private payer lab test price data under the Protecting Access to Medicare Act, but the unbundling of certain test panels could be problematic. Problems can occur when labs either did

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The Bad News: Disruption. The Good News: Opportunity!

By Robert Michel, from the Volume XXVI No. 7 – May 20, 2019 issue

CEO SUMMARY: There was an interesting consensus that emerged from the 80 sessions and 118 speakers at this year’s Executive War College in New Orleans earlier this month. The consensus centered around two themes. One theme is disruption, which is bad news for those labs that hope to maintain the status quo. The other theme

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New UnitedHealthCare Preferred Lab Network Launches July 1

By Mary Van Doren

This is an excerpt from a 1,900-word article in the April 29, 2019 issue of THE DARK REPORT. The full article is available to members of The Dark Intelligence Group.

CEO SUMMARY: A new UnitedHealthCare (UHC) preferred lab network will launch July 1 with seven lab companies. In an April 22 announcement, UHC said physicians and

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ACLA: NCCI Guidelines Are a ‘Step Backwards’

By Joseph Burns, from the Volume XXVI No. 6 – April 29, 2019 issue

CEO SUMMARY: In a letter to the National Correct Coding Initiative, the American Clinical Laboratory Association (ACLA) raised significant concerns about new language in the policy manuals for Medicare and Medicaid. ACLA said the new NCCI guidelines for molecular and other tests requiring multiple steps for one specimen reduce transparency, increase the administrative burden on

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Labs Get High Denial Rates Under New NCCI Rules

By Joseph Burns, from the Volume XXVI No. 6 – April 29, 2019 issue

CEO SUMMARY: Under guidelines the National Correct Coding Initiative issued last year, many clinical laboratories are not getting paid for some tests. The rates of denial for labs running mostly molecular tests could range from 40% to 100% of revenue, one billing expert said. Implemented Jan. 1, the guidelines apply to labs running tests in

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Volume XXVI No. 8 – June 10, 2019

THE U.S. HAS LOST ALMOST 18% of its pathologists since 2007. This means the U.S. has even fewer pathologists than other countries who have already suffered adverse clinical lab quality events. TDR also digs further into what this means for the industry, finding that while salaries and benefits are increasing, higher pay will come with a heavier workload. Also, in a Clinical Lab 2.0 case study, TDR walks readers through the steps Northwell Health took to help improve patient care – and add value – by using its data to identify patients who were undiagnosed or misdiagnosed.

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Tag: clinical laboratories

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