CEO SUMMARY: In July, CMS proposed rules to cut payments under the Hospital Outpatient Prospective Payment System, the Physician Fee Schedule, and the Clinical Laboratory Fee Schedule. Under each program, the proposed payment cuts could have a significant and negative effect on the amount of payments that laboratories receive from Medicare. Two of the proposals
Tag: health reform
CEO SUMMARY: Accountable care organizations (ACOs) are already leading the shift from fee-for-service reimbursement to population payment. ACOs are leading healthcare’s evolution to preventive care, wellness, and better management of patients with chronic disease. This evolution will require that all providers, including clinical laboratories, must shift from delivering volume to producing value. In Phoenix, Arizona,
CEO SUMMARY: An accountable care organization with a strong clinical laboratory component is taking shape in Nebraska. The University of Nebraska Medical Center has developed a partnership with the Nebraska Methodist Health System to form an ACO called the Accountable Care Alliance. It will serve Nebraska and perhaps other parts of the Midwest. Both the
CEO SUMMARY: There will be an expanding role for innovative clinical labs as healthcare moves forward on its path toward personalized medicine. However, to capitalize on this opportunity, pathology groups and clinical labs will need to beef up their information systems. They will also need to recruit lab staff who are skilled in interpreting molecular
CEO SUMMARY: Both employers and health insurers are taking aggressive steps to rein in healthcare costs. Several strategies to control spending and create powerful new incentives for providers are gaining favor. At this year’s Executive War College, Paul Mango of McKinsey & Company, explained these strategies and emphasized that new models for handling health risk
CEO SUMMARY: For more than three decades, independent lab companies have waxed fat by increasing their respective market share of lab test referrals from office-based physicians. This era is poised to end as growing numbers of office-based physicians begin to practice medicine within an accountable care organization (ACO) or similar new integrated care delivery model,
CEO SUMMARY: All signs point to a potentially dismal financial outcome for the clinical lab testing industry as Congress tries to trim spending by $1.2 trillion over the next 10 years. At least three proposals to significantly cut lab test reimbursement are in active debate by federal lawmakers. One proposal calls for reinstituting the Medicare
WE ARE ONLY 120 DAYS FROM IMPLEMENTING another round of programs mandated by the Patient Protection and Affordable Care Act (PPACA) of 2010 and associated legislation. Certain programs become effective on January 1, 2012.
On that date, the transition to HIPAA form 5010 takes effect. All clinical laboratories and pathology groups should be prepared for this
IN JUST SEVEN MONTHS, the age of accountable care organizations (ACO) begins. On January 1, 2012, the Centers for Medicare and Medicaid Services (CMS) will commence contracting with ACOs.
ACOs are one of the major reforms spelled out in the 2,700-page health reform law that President Obama signed into law on March 23, 2010. Thus, it
CEO SUMMARY: In less than nine months—on January 1, 2012—the new health reform legislation mandates that Medicare commence value-based purchasing. Medicare must also begin contracting with accountable care organizations (ACO). Experts say these two developments will initiate a cycle of broad change to the nation’s healthcare system. At this year’s Executive War College, a special