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R. Lewis Dark: TennCare's Collapse and Its Lessons for Labs
How many of you have heard about the impending collapse of TennCare, the radical Medicaid experiment launched by Tennessee in 1994? It now consumes one-third of the Tennessee state budget and Governor Phil Bredesen announced that the program will probably be ended. It is likely that Tennessee will reinstate a standard Medicaid program.
I believe TennCare is a major healthcare story. It frames the upcoming Congressional battles on Social Security and Medicare reform proposals. On one hand, employers who pay health benefits and consumers now aggressively question the quality of healthcare and the inability of hospitals and physicians to control costs. On the other hand, a group of intellectuals want healthcare to be a"public good." They want to create a healthcare system which offers equal access and equal quality to all.
That's why I believe the collapse of TennCare as a Medicaid managed care experiment is relevant. As I understand it, it was crafted to conform with most of the now infamous Hillarycare proposals of the first Clinton administration. That would be logical, since then-Vice President Al Gore has close connections with Tennessee and its political establishment.
If it is true that TennCare was structured to conform with the fundamental elements of the Hillarycare proposals, then its failure is of even greater significance. Tennessee's experiment with this healthcare delivery system model is a real-world test. It can educate us about the downstream consequences of this philosophical and operational model for healthcare.
Laboratories and pathology group practices will be greatly impacted by any type of deep reforms to the existing healthcare system. That is why the debate on how to reform healthcare in general, and government-funded healthcare programs specifically, should get wide play in the laboratory press. I, for one, would like to see a detailed and objective analysis of why the TennCare health scheme failed in such a spectacular manner.
However, because it was born of political decisions ten years ago, I don't think comprehensive coverage of TennCare's failings will be widely reported by print or broadcast media. For my part, I consider TennCare's impending collapse as a first-round event. Both the Medicare and Medicaid programs face intractable problems which will inevitably force lawmakers to soon enact extensive reforms.
Change Beneath Surface
Marks 2004 Lab Stories
Lack of disruptive events during 2004
belies deeper forces triggering change
CEO SUMMARY: Presented here are The Dark Report's"Ten Biggest Lab Stories of 2004." These are the events we consider most important to the lab industry during the year. However, in contrast to past years, 2004 lacked the types of blockbuster events which radically change and reshape the competitive landscape. Instead, 2004 was a relatively quiet year and change occurred at a slower pace.
British Early-Adopter Labs
Respond to New Trends
Shift in ER and primary care emphasis
is parallel to health trends in the U.S.
CEO SUMMARY: On which side of the Atlantic are clinical labs better operated? This February will be the third consecutive year that progressive lab leaders from the USA and the United Kingdom convene in England to explore each country's laboratory best practices, to swap innovations, and to expand their professional networks."Frontiers in Laboratory Medicine" (FiLM) takes place in Birmingham, England on February 1-2, 2005.
Direct Access Testing Must Serve Consumers
Using the name"ResultsDirect,"
PAML offers public access to lab tests
CEO SUMMARY: As growing numbers of people enroll in consumer-directed healthcare benefit programs, laboratories will need to develop ways to directly service the needs of patients interested in ordering their own laboratory tests. That's one reason Pathology Associates Medical Laboratories was motivated to develop and offer direct access testing to consumers in Spokane, Washington during the past two years.
Lab IT Update: Less Complex IT Technologies
Will Propel Use of The Internet
Bar Codes vs. RFID Tags:
Labs Will Need Both
RFID technology improvements promise
rapid deployment in labs and healthcare
CEO SUMMARY: Take everything you liked about bar code tracking. Eliminate the problems of reading bar codes. What results is the promise of radio frequency identification devices, or RFIDs. In the United States, it is already finding uses in blood transfusion, patient identification, and specimen tracking. Moreover, experts predict RFID costs will decline rapidly, further encouraging its adoption.
INTELLIGENCE:
LabCorp & ChiRon
In HCV Patent Fight
MOre Physicians
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