“March 24, 2003 Intelligence: Late Breaking Lab News”

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Wholesale prices for general acute care hospitals has climbed steadily in recent months. As tracked by the U.S. Labor Department’s Wholesale Producer Price Index, hospital prices increased 0.5%. For the 12 months ending in February, hospital prices were up 4.7%. This is almost double the annual rate tracked by the Labor Department in 1999 and 2000. The hospital price index climbed 3.4% in 2002, which was the highest increase since 1995.

Here’s a new book you might find interesting. The Hitchhiker’s Guide to Improving Efficiency in the Clinical Laboratory was co-authored by Fredrick L. Kiechle, M.D. and Rhonda Ingram Main of Beaumont Health System Laboratories in Detroit, Michigan. It covers a variety of laboratory management issues to help cope with declining reimbursement and managed care. The book was published by the AACC Press.


In Massachusetts, Blue Cross Blue Shield is launching a pilot program that pays physicians for online consults with patients. The goal is to increase patient access to doctors for non-urgent medical problems. Blue Cross will pay physicians $20 for email consults about medical issues which meet certain clinical criteria. The physician will also get a co-pay from the patient of between $5 to $15. About 500 physicians will participate in the first phase of this program.

MORE ON: E-Consults

The action by Massachusetts Blue Cross Blue Shield to initiate reimbursement for email consults between patients and physicians shows how consumer demand is changing long-standing medical practices. Use of the Internet to provide healthcare services will continue to increase. As payers, physicians, and patients increase their use of Internet-based services, THE DARK REPORT expects the legal and cultural barriers against wider use of telemedicine will fall. This should benefit laboratories, because it will give them a viable way to provide added-value services in laboratory medicine, regardless of where the physician or patient is located.


Now and then THE DARK REPORT runs across a pithy comment that is worth passing along because it succinctly changes the way one might look at an issue. Today’s gem comes from Thomas Sculley, Chief Administrator of the Centers for Medicare and Medicaid Services (CMS). In a talk at a Blue Cross/Blue Shield briefing on hospital costs last December, Scully had this to say: “As an insurance model, Medicare is a joke. It’s a big price-fixing government monster that’s slow to react when we make mistakes.”


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