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health reform

CMS Proposes Yet More Cuts for 2014, Beyond

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…

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Two Omaha Med Centers Form Collaborative Lab

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 Car…

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Laboratory Offers Early Lessons in Positioning for Success with ACOs

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 re…

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Unprecedented Growth Rates for Molecular Testing

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 nee…

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Health Insurers Now Finding Ways to Cut Costs and Shed Risks

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,…

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Today’s Lab Test Model Won’t Survive Reforms

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 a…

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Congress Likely to Pass Deep Cuts in Lab Test Fees

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 fe…

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Healthcare Reform and Laboratory Testing

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 lab…

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Labs Learn About ACOs And Medical Homes

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 si…

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Time to Think About ACOs And Medical Homes

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 …

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