AT THE END OF EACH YEAR, IT IS GENERALLY EASY TO PICK OUT the stories of greatest significance for the lab industry during the previous 12 months. But what is often overlooked are the non-stories. These are the events that did not happen in the year, despite earlier occurrences and the momentum pushing certain trends forward.
During 2015, three stories meet the non-story definition. Prior to the start of the year, many experts expected that each of these stories would have significant influence on healthcare and the clinical lab industry. Events turned out differently.
The first non-story is implementation of ICD-10. On October 1, 2015, ICD-10 diagnosis codes replaced those of ICD-9. Despite all the fears and predictions of chaos in the coding and payment for provider claims, it turned out to be a non-event. Now, almost 90 days into the ICD-10 era, it is difficult to find a news story that reports major problems in how Medicare and private insurers are paying hospitals, physicians, and labs. Given the potential for severe financial disruption, this is good news for all providers.
The second non-story centers upon the lack of accelerated progress in the adoption and operation of integrated care organizations such as accountable care organizations (ACOs) and patient-centered medical homes (PCMHs) during 2015. Although the number of ACOs increased modestly during the year, collectively, ACOs and PCMHs did not greatly change the existing relationships between hospitals, physicians, and ancillary providers, including clinical labs. There was only modest progress in integrating care delivery among providers participating in ACOs, but also during 2015, most payments to providers continued as reduced fee-for-service with a year-end distribution calculated from savings in the ACO’s projected cost of care.
The third non-story during 2015 involves Meaningful Use Stage 2 and Stage 3 requirements. Unlike the early years of this federal program to encourage hospitals and physicians to adopt electronic health records, clinical labs and pathology groups were under much less pressure from clients to create LIS-to-EHR interfaces. Even the publication of proposed rules for Meaningful Use Stage 3 during 2015 did not generate much concern about compliance among providers.