| R. Lewis Dark:
Lab Strategies for Population Health Management
EXTRAORDINARY THINGS ARE HAPPENING WITHIN THE HEALTH SYSTEM of this
country. Powerful forces of change and transformation are at work in ways
that have yet to be fully understood.
The only certainty about the healthcare system we know today is that it will
look very different in the next five years. For those of you who lead clinical laboratories
and anatomic pathology groups, this presents a high-stakes challenge.
It is essential to prepare your laboratory team for the different ways that
physicians and patients will utilize laboratory testing. Similarly, payers and
employers will restructure existing health insurance plans to drive utilization
of lab testing and all clinical services in new directions. These particular developments
will be accompanied by new reimbursement arrangements.
This is why I characterize the upcoming years as “high stakes.” Lab leaders
need to take time to understand the range of transformative forces now being
unleashed by the federal government, by managed care companies, and by
employers who fund health benefits for their employees.
In developing such business strategies, lab administrators and pathologists
need to be clear about the single most important element that is undergoing
change across the entire healthcare system.We are now moving away from an
era when “one doctor treated one patient." In its place will be a primary
emphasis on “population health management."
In this issue of THE DARK REPORT, we take an important step in helping you
understand healthcare’s evolution toward the new era of population health
management. Last month, Healthcare Informatics Magazine published its
annual list of “Top Tech Trends for 2012." On pages 10-16, you will read
about these 10 trends, along with our analysis.
We think the list of top health technology trends provides a useful mirror
for lab leaders. Yes, these are the market trends and informatics needs which
have hospital and medical clinical CIOs scrambling. But if these are important
to hospitals and medical groups, they are equally important to the clinical labs
and pathology groups providing lab testing services to these providers.
As you read our analysis, keep in mind that the unifying theme of healthcare's
coming reform is the transition away from the "one doctor/one patient"
emphasis and to population health management.
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MD Self-Referral Issues
Target of Utilization Study
In-clinic histology labs and pathology services
operated by urology groups come under scrutiny
CEO SUMMARY: When it comes to the in-office ancillary service
(IOAS) exception to physician self-referral, the issue of inclinic
pathology services has become a hot potato. Publication in
Health Affairs of a study of urologists’ self-referral of their patients
for anatomic pathology services attracted national media attention.
That study was funded by a grant from two national laboratory
associations. The Large Urology Group Practice Association
was quick to weigh in with its criticisms of the study.
Hospitals Get Bad News Re: TC Grandfather Expire
Anatomic pathologists and rural hospitals need
to negotiate new payment arrangements by July 1
CEO SUMMARY: During negotiations to extend the payroll tax
cut in February, congressional negotiators agreed to end the technical
component (TC) grandfather provision for more than 1,000
rural hospitals.Seeking to save $50million annually, Congress said
anatomic pathologists would no longer be able to bill Medicare for
the TC services on surgical specimens. Pathologists now need to
negotiate with these rural hospitals over the fee for TC services
once the new law becomes effective on July 1, 2012.
Form 5010 Updates: Medicare Extends 5010 Implementation
For a Second Time, Effective July 1, 2012
Top 10 IT Trends
s Send Message for Labs and Pathology Groups
Fast Moving Developments in Health Informatics
CEO SUMMARY: Healthcare's shift away from fee for-
service medicine and toward integrated clinical care
is widely recognized. However, few lab administrators
and pathologists are aware of the even faster transformation
underway in healthcare informatics. Presented
here are the "Top 10 Tech Trends" identified last month
by Healthcare Informatics. A common theme is the need
for information technology and healthcare informatics
to serve patient care organizations, a new term that
describes care models such as accountable care organizations
(ACO) and medical homes. In similar ways, clinical
labs and pathology groups will need to deploy
robust informatics capabilities to serve providers.
LAB BRIEFS: HOSPITAL LAB CLOSED,
STAFF EVACUATED AFTER
LAB SPECIMEN SPILL
SELF-SAMPLE
HPV TEST KIT ALLOWS
WOMEN TO COLLECT
THEIR OWN SPECIMEN
PSYCHE SYSTEMS,
SIEMENS ENTER ALLIANCE
TO INTEGRATE LIS AND
PATHOLOGY LIS
INTELLIGENCE: Late & Latent
MAYO PICKS
FIRM TO DO
WHOLE GENOME
SEQUENCING
CombiMatrix Corporation,
of Irvine, California, announced
that Richard Hockett, M.D.,
will be the company's new
Medical Director
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