| R. Lewis Dark:
Healthcare Reform and Laboratory Testing
WE ARE ONLY 120 days from Implementing another round of programs
mandated by the Patient Protection and Affordable Care Act (PPACA) of
2010 and associated legislation. Certain programs become effective on
January 1, 2012.
On that date, the transition to HIPAA form 5010 (See Dark Daily HIPAA 5010 Audio Recordings) takes effect. All clinical
laboratories and pathology groups should be prepared for this step. Use of
this form by providers and payers is a necessary step if the scheduled implementation
of ICD-10 codes in 2013 is to prove successful.
Effective on January 1, 2012, the Centers for Medicare and Medicaid
Services (CMS) can begin contracting with accountable care organizations
(ACO). CMS issued a draft of the rules for this program earlier this year.
National associations for hospitals and physicians responded with plenty of
criticism about the proposed language of these rules. Nonetheless, CMS will
be taking forward steps to begin contracting with ACOs after the New Year.
Another significant program that launches during 2012 is medicare's
value-based purchasing (vBP) program for hospitals. It becomes effective on
October 1, 2012. This is an important reform because it represents a major
effort to begin evolving the existing fee-for-service system towards a reimbursement
model that rewards providers for improving outcomes across an
identified population of patients that meet or exceed pre-established targets.
Of course, I don't need to tell you that, at the same time thatmajor efforts to
reformhealthcare like those described above are happening, themarketplace for
clinical laboratory and pathology testing continues to evolve at its own rapid
pace. New buyers are flooding into the market looking for lab companies they
can buy, for example. Of course, specialist physicians continue to open their
own in-clinic pathology laboratories, thus reducing the access to specimens for
many community hospital-based pathology groups. (See pages 3-8.)
Taken collectively, these events cannot be ignored by pathologists and
lab administrators tasked with developing the strategies their lab organizations
need to deliver state-of-the-art lab testing services in a financially sustainable
manner. The lab testing profession is about to enter a new cycle
of accelerated health reform initiatives. That makes it imperative that every
lab organization remain nimble and open to smart changes in response to
these developments.
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How In-Clinic Path Lab
Benefits GI Practice
Specialist physicians value shorter test TAT,
more access to pathologists, and added revenue
CEO SUMMARY: In Manassas, Virginia, a five-physician gastroenterology
group is using its in-clinic anatomic pathology laboratory
to advance patient care, while boosting revenue associated
with this ancillary service. In this exclusive interview, the group's
physician business leader shares the different ways that this inhouse
pathology service benefits both patients and physicians.
Patients like the faster turnaround times for reports and doctors
like the close clinical consultations with their pathologists.
AP Labs in Doc's Clinics
Now an Established Fact
Urology and gastroenterology groups value
having an in-clinic anatomic pathology service
CEO SUMMARY: It started about eight years ago and shows no signs of slowing down. Specialist physicians, particularly urolo-
gists and gastroenterologists, have learned about the benefits of
operating their own in-clinic anatomic pathology laboratories.
One-by-one, these specialty practices are investing in this ancillary
service. As they do, local pathology groups lose access to these tis-
sue referrals. This major shift in the pathology marketplace gives
many indications that is a trend that won’t be reversed.
The Dark Index: Sonic Healthcare Ltd., Reports
Full Year Earnings For FY 2011
Australian-based laboratory company now holds
third largest share of doc’s office referral tests in U.S.
NEWSMAKER INTERVIEW: How Digital Pathology Helps
Pathologists Deliver Added Value
Recovery audit Recovery audit contractors (RAC) visiting pathology labs and groups
CEO SUMMARY: During the 1990s, the pathology profession was exploring ways to use telepathology services. But it was only in the
last decade when digital pathology technology became robust enough
to support a variety of clinical uses in anatomic pathology. One of the
first companies to offer such digital pathology systems was Aperio
Technologies, Inc., of Vista, California. Dirk G. Soenksen, M.S., M.B.A.,
is the Founder and CEO of Aperio. In this exclusive interview with THE
DARK REPORT, he discusses major trends in healthcare that are actively
reshaping the anatomic pathology profession. In part one of this two-
part interview, Soenksen provides insights that will help pathologists
and pathology group practice administrators develop effective clinical
and financial strategies for their laboratories.
MARKET STRATEGIES: Rhode Island Lab Educates
Consumers about Laboratory Prices
Canadian Journal of Pathology published
a study of factors affecting supply and demand
Georgia HIE Helps All Labs
Feed Test Data to Docs
Lab
hub will interface to physicians' EHRs to support lab orders and
lab results reporting
CEO SUMMARY: In Macon, Georgia, an innovative effort by a
k
regional extension center and a health information exchange (HIE)
will level the playing field for hospital labs and independent labs
in the state. Their goal is to build a secure and flexible clinical inte-
gration platform known as a "lab hub." This common interface will
allow all physicians in the network to use their electronic health
record (EHR) systems to order lab tests and receive structured lab
test results directly into a patient's health record. (The Central Georgia Health
Network (CGHN) and the Georgia Health
IT Regional Extension Center (GA-
HITREC) have teamed up with Halfpenny
Technologies, Inc.)
INTELLIGENCE: Late & Latent
TRICORE LABS
ANNOUNCES 15189
ACCREDITATION
TRANSITIONS: Effective September 1, 2011,
James C. New retired as CEO
of
Aurora Diagnostics
Holdings, LLC.
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