By Joseph Burns, from the Volume XXVI No. 8 – June 10, 2019 issue
CEO SUMMARY: It may be without precedent in the clinical lab industry that a laid-off lab manager launches a nonprofit mobile phlebotomy service in order to continue services to homebound patients, nursing homes, and long-term care facilities. The events in the Quad Cities of Moline, Ill. and Davenport, Iowa, are also the most recent example
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
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
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
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
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
By Joseph Burns, from the Volume XXVI No. 6 – April 29, 2019 issue
CEO SUMMARY: Across the nation, health insurers are paying less for anatomic pathology services. This shrinks pathology group revenue and reduces pathologist compensation. Savvy pathology groups are responding to this trend by reviewing long-standing processes in their coding, billing, and collections department. Their goal is to update these billing and collections processes in ways that
By Joseph Burns, from the Volume XXVI No. 6 – April 29, 2019 issue
WHEN DISCUSSING THEIR EARNINGS with Wall Street analysts in February, executives from both Laboratory Corporation of America (LabCorp) and Quest Diagnostics explained that the lab test price cuts from the Protecting Access to Medicare Act of 2014 (PAMA) were not only reducing revenue, but that many state Medicaid plans are following Medicare’s lead and cutting their
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
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
